ACINETOBACTER PERITONEAL DIALYSIS RELATED PERITONITIS

7 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-2764, Poster Board= FRI-547

Introduction:

Acinetobacter Peritonitis (AP) is a serious complication in patient with peritoneal dialysis (PD) but there are few studies. AP account for 3% of all peritonitis episodes in adults. Morbility and mortality are relatively high because it is a multidrug resistant. Complications associated are common, like a loss of peritoneal function, septic shock or dead. In Mexico there is no information.

Methods:

Retrospective clinical study at Hospital Civil de Guadalajara in México, from January 2020 until march 2023, include all patients with peritonitis with isolated microbial agent. We evaluate the clinical features, antibiotics resistance, treatments and outcomes in this patients and we compare the evolution of AP against other Peritonitis. Statistical analysis was performed by SPSS.

Results:

We found 404 cases of peritonitis with an isolated agent, of which 5.7% (n=23) were due to Acinetobacter. See table 1 and 2. Patients with AP received an empirical regimen in 52% of the cases with a double regimen based on vancomycin, 52% received a double regimen based on amikacin, in none of the cases did they receive a regimen with a double cephalosporin and only 26% had prophylaxis with fluconazole. When the cultures were obtained, the targeted antibiotic was: colistin in 13%, tigecycline in 17.4%, carbapenems in 5% and aminoglycosides in 52.1%.

 

Table 1. Characteristics patients

AP (n = 23)

Male

15 (65.2)

Age (y)

48.17±19.2

Time on dialysis

12.5±6.4

CAPD

12 (52.2)

Intermittent PD

11 (47.8)

Etiology

Diabetic

Hypertensive

Glomerulonephritis

Obstructive

Unknown

 

14 (60.9)

2 (8.6)

0

1 (4.3)

6 (26.1)

Hemoglobin (g/dL)

8.8±2.0

Urea (mg/dL)

185.2±90

SCr (mg/dL)

10.99±6.3

Albumin (g/dL)

1.66±0.58

Exit site infection

5 (23.8)

Tip repositioning

5 (23.8)

Type:

A.    Baumannii

A.    Junii

A.    Iwoffi

 

19 (82.6)

2 (8.7)

2 (8.7)

 

Table 2. Comparative Outcomes

Acinetobacter Peritonitis(n=23)

Other agents Peritonitis (n=381)

P value

Diabetes

14 (63.6)

137 (42.2)

0.041

Intermittent PD

11 (47.8)

141 (51.5)

0.453

Relapse

2 (9.5)

33 (10.7)

0.611

Refractory

7 (31.8)

66 (21.3)

0.185

Septic shock

7(30.4)

49 (16.8)

0.092

Catheter loss

15 (71.4)

188 (60.3)

0.575

Loss of PD modality

13 (61.9)

140 (47)

0.136

Hospital days

17.35±10.5

15.39±9.4

0.426

Mortality

6 (27.3)

29 (9.5)

0.023

6 month survival

12 (85.7)

177 (80.5)

0.473

 

Conclusions:

Acinetobacter peritonitis is a rare but serious complication of PD, in our study the incidence was higher than reported in the literature, but 50% of AP were sensitive to aminoglycosides. Diabetes was the only predisposing factor. We observed higher mortality in this patients, therefore, early detection and targeted treatment are important to reduce complications.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.