Introduction:
The objective of this study was to systematically analyze the clinical manifestations and outcomes of gram-negative bacterial peritonitis in patients undergoing peritoneal dialysis (PD). The goal being to derive insights that can inform and enhance clinical practices regarding diagnosis, therapeutic interventions, and prevention of this condition.
Methods:
In this retrospective cohort study, we evaluated patients diagnosed with PD-related gram-negative bacterial peritonitis between 1st January 2016 to 31st December 2023. Classification of the patients was guided by the International Society for Peritoneal Dialysis (ISPD) guidelines and included various clinical endpoints such as medical cure, treatment refractoriness, recurrence, relapse, repeat peritonitis, catheter removal, transition to hemodialysis, and mortality.
Results:
The cohort comprised 125 PD patients with confirmed gram-negative bacterial infections, among whom Pseudomonas aeruginosa was identified as the predominant pathogen, present in 44.8% of cases. Clinical outcomes were diverse, with 39.1% achieving a complete medical cure. Refractory infections were observed in 20% of the patients, while 8% encountered relapses and 6.4% suffered repeat peritonitis episodes. Catheter removal was necessary in 30.4% of the cases, and 29.6% of the patients were transitioned to hemodialysis. Notably, the study reported no mortality.
Conclusions:
The rising incidence of gram-negative bacterial peritonitis in PD patients, with a significant predominance of Pseudomonas aeruginosa, highlights the urgent need for enhanced diagnostic accuracy and therapeutic strategies. This study contributes critical data on the clinical spectrum of this infection, emphasizing the necessity for targeted improvements in patient management protocols and preventive measures to mitigate the impact of this severe complication in the PD population.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.