[Microbiological diagnosis of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. Review of 5 years at the Hospital de Galdakao].

BACKGROUND

With the aim of knowing the etiology of infectious peritonitis in patients undergoing continuous ambulatory peritoneal dialysis in our Hospital and the yield of our method of culture, we have made a revision of cases recorded during a five years period.

METHODS

The peritoneal fluids of 105 patients with peritonitis was processed as following: 10 ml of uncentrifuged liquid was placed in hemocultures bottles, aerobe and anaerobe (Hemoline, Biomérieux) and incubated for up to 15 days at 37 degrees C. An additional 50 ml of peritoneal fluid was centrifuged and the sediment used for Gram stain and placed on enriched chocolate agar. Plates were incubated for up to two days at 37 degrees C in 5% of CO2. During the last year of the review the sediment of 50 ml resuspended in sterile distilled water was placed, too, in hemoculture bottles. In 18 cases we had only the hemoculture bottles inoculated by the nurse of the Nephrology Service (those patients came at a time when the laboratory was closed). Subcultures were identified with routine methodology.

RESULTS

96 (91.43%) of the 105 dialysis effluents processed were culture positive; 91.67% were bacterial and 8.33% fungal peritonitis. 64 (69.56%) of the bacterial isolates were Gram positive and 28 (30.43%) Gram negative.

CONCLUSION

We remark the good yield of a simple culture method and the high rate of Gram negative and fungal peritonitis.