Predictors and outcomes of fungal peritonitis in peritoneal dialysis patients
Fungal peritonitis is a serious complication of peritoneal dialysis but previous reports on this have been limited to small, single-center studies. Using all Australian peritoneal dialysis patients, we measured predictors, treatments, and outcomes of this condition by logistic regression and multile...
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| Veröffentlicht in: | Kidney international 2009-09, Vol.76 (6), p.622-628 |
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| creator | Miles, Rhianna Hawley, Carmel M. McDonald, Stephen P. Brown, Fiona G. Rosman, Johan B. Wiggins, Kathryn J. Bannister, Kym M. Johnson, David W. |
| description | Fungal peritonitis is a serious complication of peritoneal dialysis but previous reports on this have been limited to small, single-center studies. Using all Australian peritoneal dialysis patients, we measured predictors, treatments, and outcomes of this condition by logistic regression and multilevel, multivariate Poisson regression. This encompassed 66 centers over a 4-year period that included 162 episodes of fungal peritonitis (4.5% of all peritonitis episodes) that occurred in 158 individuals. Candida albicans (25%) and other Candida species (44%) were the most common fungi isolated. Fungal peritonitis was independently predicted by indigenous race and prior treatment of bacterial peritonitis. Peritonitis episodes occurring after 7 and 60 days of treatment for previous bacterial peritonitis decreases in the probability of fungal peritonitis 23 and 6%, respectively. Compared with other organisms, fungal peritonitis was associated with significantly higher rates of hospitalization, catheter removal, transfer to permanent hemodialysis, and death. The risks of repeat fungal peritonitis and death were lowest with catheter removal combined with antifungal therapy when compared to either intervention alone. Our study shows that fungal peritonitis is a serious complication of peritoneal dialysis and should be strongly suspected in the context of recent antibiotic treatment for bacterial peritonitis. |
| doi_str_mv | 10.1038/ki.2009.202 |
| format | Article |
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Using all Australian peritoneal dialysis patients, we measured predictors, treatments, and outcomes of this condition by logistic regression and multilevel, multivariate Poisson regression. This encompassed 66 centers over a 4-year period that included 162 episodes of fungal peritonitis (4.5% of all peritonitis episodes) that occurred in 158 individuals. Candida albicans (25%) and other Candida species (44%) were the most common fungi isolated. Fungal peritonitis was independently predicted by indigenous race and prior treatment of bacterial peritonitis. Peritonitis episodes occurring after 7 and 60 days of treatment for previous bacterial peritonitis decreases in the probability of fungal peritonitis 23 and 6%, respectively. Compared with other organisms, fungal peritonitis was associated with significantly higher rates of hospitalization, catheter removal, transfer to permanent hemodialysis, and death. The risks of repeat fungal peritonitis and death were lowest with catheter removal combined with antifungal therapy when compared to either intervention alone. Our study shows that fungal peritonitis is a serious complication of peritoneal dialysis and should be strongly suspected in the context of recent antibiotic treatment for bacterial peritonitis.</description><identifier>ISSN: 0085-2538</identifier><identifier>EISSN: 1523-1755</identifier><identifier>DOI: 10.1038/ki.2009.202</identifier><identifier>PMID: 19516241</identifier><identifier>CODEN: KDYIA5</identifier><language>eng</language><publisher>Basingstoke: Elsevier Inc</publisher><subject>Abdomen ; Adult ; Aged ; antifungal agents ; Antifungal Agents - therapeutic use ; Australia - epidemiology ; Biological and medical sciences ; Candida ; Candida albicans ; Female ; fungus ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Mycoses - drug therapy ; Mycoses - epidemiology ; Nephrology. Urinary tract diseases ; Other diseases. Semiology ; outcomes ; Peritoneal Dialysis - adverse effects ; peritonitis ; Peritonitis - drug therapy ; Peritonitis - epidemiology ; Poisson Distribution ; Time Factors ; yeast</subject><ispartof>Kidney international, 2009-09, Vol.76 (6), p.622-628</ispartof><rights>2009 International Society of Nephrology</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Sep 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c524t-c8cbd0c49efbf5212e92359032260c037660062e9a59a9da98dab22b326219e73</citedby><cites>FETCH-LOGICAL-c524t-c8cbd0c49efbf5212e92359032260c037660062e9a59a9da98dab22b326219e73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21900851$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19516241$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miles, Rhianna</creatorcontrib><creatorcontrib>Hawley, Carmel M.</creatorcontrib><creatorcontrib>McDonald, Stephen P.</creatorcontrib><creatorcontrib>Brown, Fiona G.</creatorcontrib><creatorcontrib>Rosman, Johan B.</creatorcontrib><creatorcontrib>Wiggins, Kathryn J.</creatorcontrib><creatorcontrib>Bannister, Kym M.</creatorcontrib><creatorcontrib>Johnson, David W.</creatorcontrib><title>Predictors and outcomes of fungal peritonitis in peritoneal dialysis patients</title><title>Kidney international</title><addtitle>Kidney Int</addtitle><description>Fungal peritonitis is a serious complication of peritoneal dialysis but previous reports on this have been limited to small, single-center studies. Using all Australian peritoneal dialysis patients, we measured predictors, treatments, and outcomes of this condition by logistic regression and multilevel, multivariate Poisson regression. This encompassed 66 centers over a 4-year period that included 162 episodes of fungal peritonitis (4.5% of all peritonitis episodes) that occurred in 158 individuals. Candida albicans (25%) and other Candida species (44%) were the most common fungi isolated. Fungal peritonitis was independently predicted by indigenous race and prior treatment of bacterial peritonitis. Peritonitis episodes occurring after 7 and 60 days of treatment for previous bacterial peritonitis decreases in the probability of fungal peritonitis 23 and 6%, respectively. Compared with other organisms, fungal peritonitis was associated with significantly higher rates of hospitalization, catheter removal, transfer to permanent hemodialysis, and death. The risks of repeat fungal peritonitis and death were lowest with catheter removal combined with antifungal therapy when compared to either intervention alone. Our study shows that fungal peritonitis is a serious complication of peritoneal dialysis and should be strongly suspected in the context of recent antibiotic treatment for bacterial peritonitis.</description><subject>Abdomen</subject><subject>Adult</subject><subject>Aged</subject><subject>antifungal agents</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Australia - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Candida</subject><subject>Candida albicans</subject><subject>Female</subject><subject>fungus</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mycoses - drug therapy</subject><subject>Mycoses - epidemiology</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Other diseases. Semiology</subject><subject>outcomes</subject><subject>Peritoneal Dialysis - adverse effects</subject><subject>peritonitis</subject><subject>Peritonitis - drug therapy</subject><subject>Peritonitis - epidemiology</subject><subject>Poisson Distribution</subject><subject>Time Factors</subject><subject>yeast</subject><issn>0085-2538</issn><issn>1523-1755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkc1r3DAQxUVoabZpT7kXU0gvxelotLKtYwj9gpTmkJ6FLI-LEq-1leRA_vvOstsESqGXETP6Mcx7T4hTCecSVPfhLpwjgOGCR2IlNapatlo_EyuATteoVXcsXuZ8C9wbBS_EsTRaNriWK_HtOtEQfIkpV24eqrgUHzeUqzhW4zL_dFO1pRRKnEMJuQrzn5b4Zwhuesg83roSaC75lXg-uinT68N7In58-nhz-aW--v756-XFVe01rkvtO98P4NeGxn7UKJEMKm1AITbgQbVNA9Dw1GnjzOBMN7gesVfYoDTUqhPxbr93m-KvhXKxm5A9TZObKS7ZNi2rQ63_CyKYtVQtMPj2L_A2LmlmERYlSPaqlQy930M-xZwTjXabwsalByvB7rKwd8HusuCCTL85rFz6DQ1P7MF8Bs4OgMveTWNysw_5kWOpuwB3nN5zxJbeB0o2e7bbc3CJfLFDDP884Dc_xKH6</recordid><startdate>20090901</startdate><enddate>20090901</enddate><creator>Miles, Rhianna</creator><creator>Hawley, Carmel M.</creator><creator>McDonald, Stephen P.</creator><creator>Brown, Fiona G.</creator><creator>Rosman, Johan B.</creator><creator>Wiggins, Kathryn J.</creator><creator>Bannister, Kym M.</creator><creator>Johnson, David W.</creator><general>Elsevier Inc</general><general>Nature Publishing Group</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><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>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7QL</scope><scope>7T7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20090901</creationdate><title>Predictors and outcomes of fungal peritonitis in peritoneal dialysis patients</title><author>Miles, Rhianna ; Hawley, Carmel M. ; McDonald, Stephen P. ; Brown, Fiona G. ; Rosman, Johan B. ; Wiggins, Kathryn J. ; Bannister, Kym M. ; Johnson, David W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c524t-c8cbd0c49efbf5212e92359032260c037660062e9a59a9da98dab22b326219e73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Abdomen</topic><topic>Adult</topic><topic>Aged</topic><topic>antifungal agents</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Australia - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Candida</topic><topic>Candida albicans</topic><topic>Female</topic><topic>fungus</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mycoses - drug therapy</topic><topic>Mycoses - epidemiology</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Other diseases. Semiology</topic><topic>outcomes</topic><topic>Peritoneal Dialysis - adverse effects</topic><topic>peritonitis</topic><topic>Peritonitis - drug therapy</topic><topic>Peritonitis - epidemiology</topic><topic>Poisson Distribution</topic><topic>Time Factors</topic><topic>yeast</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miles, Rhianna</creatorcontrib><creatorcontrib>Hawley, Carmel M.</creatorcontrib><creatorcontrib>McDonald, Stephen P.</creatorcontrib><creatorcontrib>Brown, Fiona G.</creatorcontrib><creatorcontrib>Rosman, Johan B.</creatorcontrib><creatorcontrib>Wiggins, Kathryn J.</creatorcontrib><creatorcontrib>Bannister, Kym M.</creatorcontrib><creatorcontrib>Johnson, David W.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Kidney international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miles, Rhianna</au><au>Hawley, Carmel M.</au><au>McDonald, Stephen P.</au><au>Brown, Fiona G.</au><au>Rosman, Johan B.</au><au>Wiggins, Kathryn J.</au><au>Bannister, Kym M.</au><au>Johnson, David W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors and outcomes of fungal peritonitis in peritoneal dialysis patients</atitle><jtitle>Kidney international</jtitle><addtitle>Kidney Int</addtitle><date>2009-09-01</date><risdate>2009</risdate><volume>76</volume><issue>6</issue><spage>622</spage><epage>628</epage><pages>622-628</pages><issn>0085-2538</issn><eissn>1523-1755</eissn><coden>KDYIA5</coden><abstract>Fungal peritonitis is a serious complication of peritoneal dialysis but previous reports on this have been limited to small, single-center studies. Using all Australian peritoneal dialysis patients, we measured predictors, treatments, and outcomes of this condition by logistic regression and multilevel, multivariate Poisson regression. This encompassed 66 centers over a 4-year period that included 162 episodes of fungal peritonitis (4.5% of all peritonitis episodes) that occurred in 158 individuals. Candida albicans (25%) and other Candida species (44%) were the most common fungi isolated. Fungal peritonitis was independently predicted by indigenous race and prior treatment of bacterial peritonitis. Peritonitis episodes occurring after 7 and 60 days of treatment for previous bacterial peritonitis decreases in the probability of fungal peritonitis 23 and 6%, respectively. Compared with other organisms, fungal peritonitis was associated with significantly higher rates of hospitalization, catheter removal, transfer to permanent hemodialysis, and death. The risks of repeat fungal peritonitis and death were lowest with catheter removal combined with antifungal therapy when compared to either intervention alone. Our study shows that fungal peritonitis is a serious complication of peritoneal dialysis and should be strongly suspected in the context of recent antibiotic treatment for bacterial peritonitis.</abstract><cop>Basingstoke</cop><pub>Elsevier Inc</pub><pmid>19516241</pmid><doi>10.1038/ki.2009.202</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Abdomen Adult Aged antifungal agents Antifungal Agents - therapeutic use Australia - epidemiology Biological and medical sciences Candida Candida albicans Female fungus Gastroenterology. Liver. Pancreas. Abdomen Humans Logistic Models Male Medical sciences Middle Aged Mycoses - drug therapy Mycoses - epidemiology Nephrology. Urinary tract diseases Other diseases. Semiology outcomes Peritoneal Dialysis - adverse effects peritonitis Peritonitis - drug therapy Peritonitis - epidemiology Poisson Distribution Time Factors yeast |
| title | Predictors and outcomes of fungal peritonitis in peritoneal dialysis patients |
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