Microbiology and outcomes of polymicrobial peritonitis associated with peritoneal dialysis: a register-based cohort study from the French Language Peritoneal Dialysis Registry
ABSTRACT Background Previous studies have reported that polymicrobial peritonitis in peritoneal dialysis (PD) is associated with poor outcomes, but recent data from European cohorts are scarce. Methods We included from the French Language Peritoneal Dialysis Registry all patients ≥18 years of age wh...
Gespeichert in:
| Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2023-05, Vol.38 (5), p.1271-1281 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1281 |
|---|---|
| container_issue | 5 |
| container_start_page | 1271 |
| container_title | Nephrology, dialysis, transplantation |
| container_volume | 38 |
| creator | Forté, Valentine Novelli, Sophie Zaidan, Mohamad Snanoudj, Renaud Verger, Christian Beaudreuil, Séverine |
| description | ABSTRACT
Background
Previous studies have reported that polymicrobial peritonitis in peritoneal dialysis (PD) is associated with poor outcomes, but recent data from European cohorts are scarce.
Methods
We included from the French Language Peritoneal Dialysis Registry all patients ≥18 years of age who started PD between January 2014 and November 2020. We compared microbiology and patient characteristics associated with mono- and polymicrobial peritonitis. We assessed patient outcomes after a first polymicrobial peritonitis using survival analysis with competing events. We differentiated microorganisms isolated from dialysis effluent as enteric or non-enteric pathogens.
Results
A total of 8848 patients contributed 13 023 patient-years of follow-up and 3348 culture-positive peritonitis episodes, including 251 polymicrobial ones. This corresponded to rates of 0.32 and 0.02 episodes/patient-year, respectively. For most patients (72%) who experienced polymicrobial peritonitis, this was their first peritonitis episode. Enteric pathogens were more frequently isolated in polymicrobial than in monomicrobial peritonitis (57 versus 44%; P |
| doi_str_mv | 10.1093/ndt/gfac267 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_04122494v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ndt/gfac267</oup_id><sourcerecordid>2716932097</sourcerecordid><originalsourceid>FETCH-LOGICAL-c354t-41f5d274bb8e157160d2c83cca05109d4cb1fc8bea0f282b8fdc08a015aedd253</originalsourceid><addsrcrecordid>eNp90cFu1DAQBmALgei2cOKOfEJUKNR2kk3CrSqUIi0CIThbE3ucGCVxsB1QnopXxCXbcuNkaebTb2l-Qp5x9pqzJr-YdLzoDCixrx6QHS_2LBN5XT4ku7TlGStZc0JOQ_jOGGtEVT0mJ_me56yu2I78_miVd611g-tWCpOmbonKjRioM3R2wzpuAAY6o7fRTTbaQCEEpyxE1PSXjf3dDhPTya7BhjcUqMfOhog-ayEkqlzvfKQhLnqlxruRxh7ptcdJ9fQAU7dAh_Tzv6y3xyz65W-QX5-QRwaGgE-P7xn5dv3u69VNdvj0_sPV5SFTeVnErOCm1KIq2rZGXlZ8z7RQda4UsDIdTReq5UbVLQIzohZtbbRiNTBeAmotyvyMnG-5PQxy9nYEv0oHVt5cHuTtjBVciKIpfvJkX2529u7HgiHK0QaFwwATuiVIkf5vcsGaKtFXG003DcGjuc_mTN62KVOb8thm0s-PwUs7or63d_Ul8GIDbpn_m_QHtHet4w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2716932097</pqid></control><display><type>article</type><title>Microbiology and outcomes of polymicrobial peritonitis associated with peritoneal dialysis: a register-based cohort study from the French Language Peritoneal Dialysis Registry</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Forté, Valentine ; Novelli, Sophie ; Zaidan, Mohamad ; Snanoudj, Renaud ; Verger, Christian ; Beaudreuil, Séverine</creator><creatorcontrib>Forté, Valentine ; Novelli, Sophie ; Zaidan, Mohamad ; Snanoudj, Renaud ; Verger, Christian ; Beaudreuil, Séverine</creatorcontrib><description>ABSTRACT
Background
Previous studies have reported that polymicrobial peritonitis in peritoneal dialysis (PD) is associated with poor outcomes, but recent data from European cohorts are scarce.
Methods
We included from the French Language Peritoneal Dialysis Registry all patients ≥18 years of age who started PD between January 2014 and November 2020. We compared microbiology and patient characteristics associated with mono- and polymicrobial peritonitis. We assessed patient outcomes after a first polymicrobial peritonitis using survival analysis with competing events. We differentiated microorganisms isolated from dialysis effluent as enteric or non-enteric pathogens.
Results
A total of 8848 patients contributed 13 023 patient-years of follow-up and 3348 culture-positive peritonitis episodes, including 251 polymicrobial ones. This corresponded to rates of 0.32 and 0.02 episodes/patient-year, respectively. For most patients (72%) who experienced polymicrobial peritonitis, this was their first peritonitis episode. Enteric pathogens were more frequently isolated in polymicrobial than in monomicrobial peritonitis (57 versus 44%; P < .001). In both cases of peritonitis with and without enteric pathogens, the polymicrobial versus monomicrobial character of the peritonitis was not associated with mortality in patients who did not switch to haemodialysis {adjusted cause-specific hazard ratio [acsHR] 1.2 [95% confidence interval (CI) 0.3–5.0], P = .78 and 1.1 [95% CI 0.7–1.8], P = .73, respectively}. However, the risks of death and switch to haemodialysis were higher for monomicrobial peritonitis with enteric pathogens compared with those without [acsHR 1.3 (95% CI 1.1–1.7), P = .02 and 1.9 (95% CI 1.5–2.4), P < .0001, respectively].
Conclusion
Isolation of enteric pathogens, rather than the polymicrobial character of the peritonitis, is associated with poorer outcomes.</description><identifier>ISSN: 0931-0509</identifier><identifier>ISSN: 1460-2385</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfac267</identifier><identifier>PMID: 36130870</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Cohort Studies ; Humans ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - therapy ; Language ; Life Sciences ; Peritoneal Dialysis - adverse effects ; Peritonitis - epidemiology ; Peritonitis - etiology ; Registries ; Renal Dialysis ; Retrospective Studies ; Risk Factors</subject><ispartof>Nephrology, dialysis, transplantation, 2023-05, Vol.38 (5), p.1271-1281</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the ERA. 2022</rights><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c354t-41f5d274bb8e157160d2c83cca05109d4cb1fc8bea0f282b8fdc08a015aedd253</citedby><cites>FETCH-LOGICAL-c354t-41f5d274bb8e157160d2c83cca05109d4cb1fc8bea0f282b8fdc08a015aedd253</cites><orcidid>0000-0002-8009-5366 ; 0000-0003-0154-9786 ; 0000-0002-6657-6235</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36130870$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-04122494$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Forté, Valentine</creatorcontrib><creatorcontrib>Novelli, Sophie</creatorcontrib><creatorcontrib>Zaidan, Mohamad</creatorcontrib><creatorcontrib>Snanoudj, Renaud</creatorcontrib><creatorcontrib>Verger, Christian</creatorcontrib><creatorcontrib>Beaudreuil, Séverine</creatorcontrib><title>Microbiology and outcomes of polymicrobial peritonitis associated with peritoneal dialysis: a register-based cohort study from the French Language Peritoneal Dialysis Registry</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><description>ABSTRACT
Background
Previous studies have reported that polymicrobial peritonitis in peritoneal dialysis (PD) is associated with poor outcomes, but recent data from European cohorts are scarce.
Methods
We included from the French Language Peritoneal Dialysis Registry all patients ≥18 years of age who started PD between January 2014 and November 2020. We compared microbiology and patient characteristics associated with mono- and polymicrobial peritonitis. We assessed patient outcomes after a first polymicrobial peritonitis using survival analysis with competing events. We differentiated microorganisms isolated from dialysis effluent as enteric or non-enteric pathogens.
Results
A total of 8848 patients contributed 13 023 patient-years of follow-up and 3348 culture-positive peritonitis episodes, including 251 polymicrobial ones. This corresponded to rates of 0.32 and 0.02 episodes/patient-year, respectively. For most patients (72%) who experienced polymicrobial peritonitis, this was their first peritonitis episode. Enteric pathogens were more frequently isolated in polymicrobial than in monomicrobial peritonitis (57 versus 44%; P < .001). In both cases of peritonitis with and without enteric pathogens, the polymicrobial versus monomicrobial character of the peritonitis was not associated with mortality in patients who did not switch to haemodialysis {adjusted cause-specific hazard ratio [acsHR] 1.2 [95% confidence interval (CI) 0.3–5.0], P = .78 and 1.1 [95% CI 0.7–1.8], P = .73, respectively}. However, the risks of death and switch to haemodialysis were higher for monomicrobial peritonitis with enteric pathogens compared with those without [acsHR 1.3 (95% CI 1.1–1.7), P = .02 and 1.9 (95% CI 1.5–2.4), P < .0001, respectively].
Conclusion
Isolation of enteric pathogens, rather than the polymicrobial character of the peritonitis, is associated with poorer outcomes.</description><subject>Cohort Studies</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Language</subject><subject>Life Sciences</subject><subject>Peritoneal Dialysis - adverse effects</subject><subject>Peritonitis - epidemiology</subject><subject>Peritonitis - etiology</subject><subject>Registries</subject><subject>Renal Dialysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>0931-0509</issn><issn>1460-2385</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90cFu1DAQBmALgei2cOKOfEJUKNR2kk3CrSqUIi0CIThbE3ucGCVxsB1QnopXxCXbcuNkaebTb2l-Qp5x9pqzJr-YdLzoDCixrx6QHS_2LBN5XT4ku7TlGStZc0JOQ_jOGGtEVT0mJ_me56yu2I78_miVd611g-tWCpOmbonKjRioM3R2wzpuAAY6o7fRTTbaQCEEpyxE1PSXjf3dDhPTya7BhjcUqMfOhog-ayEkqlzvfKQhLnqlxruRxh7ptcdJ9fQAU7dAh_Tzv6y3xyz65W-QX5-QRwaGgE-P7xn5dv3u69VNdvj0_sPV5SFTeVnErOCm1KIq2rZGXlZ8z7RQda4UsDIdTReq5UbVLQIzohZtbbRiNTBeAmotyvyMnG-5PQxy9nYEv0oHVt5cHuTtjBVciKIpfvJkX2529u7HgiHK0QaFwwATuiVIkf5vcsGaKtFXG003DcGjuc_mTN62KVOb8thm0s-PwUs7or63d_Ul8GIDbpn_m_QHtHet4w</recordid><startdate>20230504</startdate><enddate>20230504</enddate><creator>Forté, Valentine</creator><creator>Novelli, Sophie</creator><creator>Zaidan, Mohamad</creator><creator>Snanoudj, Renaud</creator><creator>Verger, Christian</creator><creator>Beaudreuil, Séverine</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-8009-5366</orcidid><orcidid>https://orcid.org/0000-0003-0154-9786</orcidid><orcidid>https://orcid.org/0000-0002-6657-6235</orcidid></search><sort><creationdate>20230504</creationdate><title>Microbiology and outcomes of polymicrobial peritonitis associated with peritoneal dialysis: a register-based cohort study from the French Language Peritoneal Dialysis Registry</title><author>Forté, Valentine ; Novelli, Sophie ; Zaidan, Mohamad ; Snanoudj, Renaud ; Verger, Christian ; Beaudreuil, Séverine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c354t-41f5d274bb8e157160d2c83cca05109d4cb1fc8bea0f282b8fdc08a015aedd253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cohort Studies</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Language</topic><topic>Life Sciences</topic><topic>Peritoneal Dialysis - adverse effects</topic><topic>Peritonitis - epidemiology</topic><topic>Peritonitis - etiology</topic><topic>Registries</topic><topic>Renal Dialysis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Forté, Valentine</creatorcontrib><creatorcontrib>Novelli, Sophie</creatorcontrib><creatorcontrib>Zaidan, Mohamad</creatorcontrib><creatorcontrib>Snanoudj, Renaud</creatorcontrib><creatorcontrib>Verger, Christian</creatorcontrib><creatorcontrib>Beaudreuil, Séverine</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Forté, Valentine</au><au>Novelli, Sophie</au><au>Zaidan, Mohamad</au><au>Snanoudj, Renaud</au><au>Verger, Christian</au><au>Beaudreuil, Séverine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Microbiology and outcomes of polymicrobial peritonitis associated with peritoneal dialysis: a register-based cohort study from the French Language Peritoneal Dialysis Registry</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2023-05-04</date><risdate>2023</risdate><volume>38</volume><issue>5</issue><spage>1271</spage><epage>1281</epage><pages>1271-1281</pages><issn>0931-0509</issn><issn>1460-2385</issn><eissn>1460-2385</eissn><abstract>ABSTRACT
Background
Previous studies have reported that polymicrobial peritonitis in peritoneal dialysis (PD) is associated with poor outcomes, but recent data from European cohorts are scarce.
Methods
We included from the French Language Peritoneal Dialysis Registry all patients ≥18 years of age who started PD between January 2014 and November 2020. We compared microbiology and patient characteristics associated with mono- and polymicrobial peritonitis. We assessed patient outcomes after a first polymicrobial peritonitis using survival analysis with competing events. We differentiated microorganisms isolated from dialysis effluent as enteric or non-enteric pathogens.
Results
A total of 8848 patients contributed 13 023 patient-years of follow-up and 3348 culture-positive peritonitis episodes, including 251 polymicrobial ones. This corresponded to rates of 0.32 and 0.02 episodes/patient-year, respectively. For most patients (72%) who experienced polymicrobial peritonitis, this was their first peritonitis episode. Enteric pathogens were more frequently isolated in polymicrobial than in monomicrobial peritonitis (57 versus 44%; P < .001). In both cases of peritonitis with and without enteric pathogens, the polymicrobial versus monomicrobial character of the peritonitis was not associated with mortality in patients who did not switch to haemodialysis {adjusted cause-specific hazard ratio [acsHR] 1.2 [95% confidence interval (CI) 0.3–5.0], P = .78 and 1.1 [95% CI 0.7–1.8], P = .73, respectively}. However, the risks of death and switch to haemodialysis were higher for monomicrobial peritonitis with enteric pathogens compared with those without [acsHR 1.3 (95% CI 1.1–1.7), P = .02 and 1.9 (95% CI 1.5–2.4), P < .0001, respectively].
Conclusion
Isolation of enteric pathogens, rather than the polymicrobial character of the peritonitis, is associated with poorer outcomes.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>36130870</pmid><doi>10.1093/ndt/gfac267</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-8009-5366</orcidid><orcidid>https://orcid.org/0000-0003-0154-9786</orcidid><orcidid>https://orcid.org/0000-0002-6657-6235</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0931-0509 |
| ispartof | Nephrology, dialysis, transplantation, 2023-05, Vol.38 (5), p.1271-1281 |
| issn | 0931-0509 1460-2385 1460-2385 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_04122494v1 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Cohort Studies Humans Kidney Failure, Chronic - complications Kidney Failure, Chronic - therapy Language Life Sciences Peritoneal Dialysis - adverse effects Peritonitis - epidemiology Peritonitis - etiology Registries Renal Dialysis Retrospective Studies Risk Factors |
| title | Microbiology and outcomes of polymicrobial peritonitis associated with peritoneal dialysis: a register-based cohort study from the French Language Peritoneal Dialysis Registry |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T00%3A08%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_hal_p&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Microbiology%20and%20outcomes%20of%20polymicrobial%20peritonitis%20associated%20with%20peritoneal%20dialysis:%20a%20register-based%20cohort%20study%20from%20the%20French%20Language%20Peritoneal%20Dialysis%20Registry&rft.jtitle=Nephrology,%20dialysis,%20transplantation&rft.au=Fort%C3%A9,%20Valentine&rft.date=2023-05-04&rft.volume=38&rft.issue=5&rft.spage=1271&rft.epage=1281&rft.pages=1271-1281&rft.issn=0931-0509&rft.eissn=1460-2385&rft_id=info:doi/10.1093/ndt/gfac267&rft_dat=%3Cproquest_hal_p%3E2716932097%3C/proquest_hal_p%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2716932097&rft_id=info:pmid/36130870&rft_oup_id=10.1093/ndt/gfac267&rfr_iscdi=true |