Abstract
In 2016, the International Society of Peritoneal Dialysis (ISPD) published guidelines that focus on the importance of both prevention and treatment of peritonitis. For once more, the need for annual reporting of peritonitis rates and recording of peritonitis and exit-site infections, isolated microorganism and antimicrobial susceptibilities as a central component of a quality improvement program is highlighted. Data on new antibiotic regimens, techniques for microorganism isolation and peritoneal dialysis solutions are included. Training of both peritoneal dialysis nurses and patients seems to be crucial, while the modifiable risk factors for peritonitis seem to be of great interest. In this article, we record the changes in the last ISPD (2016) guidelines compared to the previous ones published in 2010.
Similar content being viewed by others
References
Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, Fish DN, Goffin E, Kim YL, Salzer W, Struijk DG, Teitelbaum I, Johnson DW (2016) ISPD peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int 36(5):481–508. doi:10.3747/pdi.2016.00078
Piraino B, Bailie GR, Bernardini J, Boeschoten E, Gupta A, Holmes C, Kuijper EJ, Li PK, Lye WC, Mujais S, Paterson DL, Fontan MP, Ramos A, Schaefer F, Uttley L, Committee IAHA (2005) Peritoneal dialysis-related infections recommendations: 2005 update. Perit Dial Int 25(2):107–131
Li PK, Szeto CC, Piraino B, Bernardini J, Figueiredo AE, Gupta A, Johnson DW, Kuijper EJ, Lye WC, Salzer W, Schaefer F, Struijk DG, International Society for Peritoneal D (2010) Peritoneal dialysis-related infections recommendations: 2010 update. Perit Dial Int 30(4):393–423. doi:10.3747/pdi.2010.00049
Nikitidou O, Liakopoulos V, Kiparissi T, Divani M, Leivaditis K, Dombros N (2012) Peritoneal dialysis-related infections recommendations: 2010 update. What is new? Int Urol Nephrol 44(2):593–600. doi:10.1007/s11255-011-9995-9
Nishina M, Yanagi H, Kakuta T, Endoh M, Fukagawa M, Takagi A (2014) A 10-year retrospective cohort study on the risk factors for peritoneal dialysis-related peritonitis: a single-center study at Tokai University Hospital. Clin Exp Nephrol 18(4):649–654. doi:10.1007/s10157-013-0872-y
Szeto CC, Li PK, Johnson DW, Bernardini J, Dong J, Figueiredo AE, Ito Y, Kazancioglu R, Moraes T, Van Esch S, Brown EA (2017) ISPD catheter-related infection recommendations: 2017 update. Perit Dial Int 37(2):141–154. doi:10.3747/pdi.2016.00120
Strippoli GF, Tong A, Johnson D, Schena FP, Craig JC (2004) Antimicrobial agents to prevent peritonitis in peritoneal dialysis: a systematic review of randomized controlled trials. Am J Kidney Dis 44(4):591–603
Hagen SM, Lafranca JA, IJzermans JN, Dor FJ (2014) A systematic review and meta-analysis of the influence of peritoneal dialysis catheter type on complication rate and catheter survival. Kidney Int 85(4):920–932. doi:10.1038/ki.2013.365
Eklund B, Honkanen E, Kyllonen L, Salmela K, Kala AR (1997) Peritoneal dialysis access: prospective randomized comparison of single-cuff and double-cuff straight Tenckhoff catheters. Nephrol Dial Transplant 12(12):2664–2666
Lo WK, Lui SL, Li FK, Choy BY, Lam MF, Tse KC, Yip TP, Ng FS, Lam SC, Chu WL, Cheng SW (2003) A prospective randomized study on three different peritoneal dialysis catheters. Perit Dial Int 23(Suppl 2):S127–131
Daly C, Cody JD, Khan I, Rabindranath KS, Vale L, Wallace SA (2014) Double bag or Y-set versus standard transfer systems for continuous ambulatory peritoneal dialysis in end-stage kidney disease. Cochrane Database Syst Rev 8:CD003078. doi:10.1002/14651858.CD003078.pub2
Figueiredo AE, Bernardini J, Bowes E, Hiramatsu M, Price V, Su C, Walker R, Brunier G (2016) A syllabus for teaching peritoneal dialysis to patients and caregivers. Perit Dial Int 36(6):592–605. doi:10.3747/pdi.2015.00277
Ellis EN, Blaszak C, Wright S, Van Lierop A (2012) Effectiveness of home visits to pediatric peritoneal dialysis patients. Perit Dial Int 32(4):419–423. doi:10.3747/pdi.2010.00145
Liakopoulos V, Leivaditis K, Nikitidou O, Divani M, Antoniadi G, Dombros N (2012) Intermittent intraperitoneal dose of teicoplanin in peritoneal dialysis-related peritonitis. Perit Dial Int 32(3):365–366. doi:10.3747/pdi.2011.00171
Bordin G, Casati M, Sicolo N, Zuccherato N, Eduati V (2007) Patient education in peritoneal dialysis: an observational study in Italy. J Ren Care 33(4):165–171
Ljungman S Prevention of peritonnitis in peritoneal dialysis (PEPS). https://clinicaltrials.gov/ct2/show/results/NCT01293799
Johnson DW, Brown FG, Clarke M, Boudville N, Elias TJ, Foo MW, Jones B, Kulkarni H, Langham R, Ranganathan D, Schollum J, Suranyi M, Tan SH, Voss D (2012) Effects of biocompatible versus standard fluid on peritoneal dialysis outcomes. J Am Soc Nephrol 23(6):1097–1107. doi:10.1681/ASN.2011121201
Cho Y, Johnson DW, Badve SV, Craig JC, Strippoli GF, Wiggins KJ (2013) The impact of neutral-pH peritoneal dialysates with reduced glucose degradation products on clinical outcomes in peritoneal dialysis patients. Kidney Int 84(5):969–979. doi:10.1038/ki.2013.190
Lloyd A, Tangri N, Shafer LA, Rigatto C, Perl J, Komenda P, Sood MM (2013) The risk of peritonitis after an exit site infection: a time-matched, case-control study. Nephrol Dial Transplant 28(7):1915–1921. doi:10.1093/ndt/gft002
Piraino B, Bernardini J, Brown E, Figueiredo A, Johnson DW, Lye WC, Price V, Ramalakshmi S, Szeto CC (2011) ISPD position statement on reducing the risks of peritoneal dialysis-related infections. Perit Dial Int 31(6):614–630. doi:10.3747/pdi.2011.00057
Davenport A (2012) Pan Thames Renal Audit Peritoneal Dialysis Group. Do topical antibiotics reduce exit site infection rates and peritonitis episodes in peritoneal dialysis patients? The Pan Thames Renal Audit. J Nephrol 25(5):819–824. doi:10.5301/jn.5000071
Wong C, Luk IW, Ip M, You JH (2014) Prevention of gram-positive infections in peritoneal dialysis patients in Hong Kong: a cost-effectiveness analysis. Am J Infect Control 42(4):412–416. doi:10.1016/j.ajic.2013.12.008
Chua AN, Goldstein SL, Bell D, Brewer ED (2009) Topical mupirocin/sodium hypochlorite reduces peritonitis and exit-site infection rates in children. Clin J Am Soc Nephrol 4(12):1939–1943. doi:10.2215/CJN.02770409
Al-Hwiesh AK, Abdul-Rahman IS, Al-Muhanna FA, Al-Sulaiman MH, Al-Jondebi MS, Divino-Filho JC (2013) Prevention of peritoneal dialysis catheter infections in Saudi peritoneal dialysis patients: the emergence of high-level mupirocin resistance. Int J Artif Organs 36(7):473–483. doi:10.5301/ijao.5000207
Aykut S, Caner C, Ozkan G, Ali C, Tugba A, Zeynep G, Taner C (2010) Mupirocin application at the exit site in peritoneal dialysis patients: five years of experience. Ren Fail 32(3):356–361. doi:10.3109/08860221003611703
Piraino B (2010) Mupirocin for preventing exit-site infection and peritonitis in patients undergoing peritoneal dialysis. Was it effective? Nephrol Dial Transplant 25(2):349–352. doi:10.1093/ndt/gfp615
Lo MW, Mak SK, Wong YY, Lo KC, Chan SF, Tong GM, Lo KY, Wong PN, Tse CW, Kam KM, Wong AK (2013) Atypical mycobacterial exit-site infection and peritonitis in peritoneal dialysis patients on prophylactic exit-site gentamicin cream. Perit Dial Int 33(3):267–272. doi:10.3747/pdi.2011.00184
Johnson DW, Badve SV, Pascoe EM, Beller E, Cass A, Clark C, de Zoysa J, Isbel NM, McTaggart S, Morrish AT, Playford EG, Scaria A, Snelling P, Vergara LA, Hawley CM, Group HSC (2014) Antibacterial honey for the prevention of peritoneal-dialysis-related infections (HONEYPOT): a randomised trial. Lancet Infect Dis 14(1):23–30. doi:10.1016/S1473-3099(13)70258-5
McQuillan RF, Chiu E, Nessim S, Lok CE, Roscoe JM, Tam P, Jassal SV (2012) A randomized controlled trial comparing mupirocin and polysporin triple ointments in peritoneal dialysis patients: the MP3 Study. Clin J Am Soc Nephrol 7(2):297–303. doi:10.2215/CJN.07970811
Wu HH, Li IJ, Weng CH, Lee CC, Chen YC, Chang MY, Fang JT, Hung CC, Yang CW, Tian YC (2013) Prophylactic antibiotics for endoscopy-associated peritonitis in peritoneal dialysis patients. PLoS ONE 8(8):e71532. doi:10.1371/journal.pone.0071532
Su CY, Pei J, Lu XH, Tang W, Wang T (2012) Gastrointestinal symptoms predict peritonitis rates in CAPD patients. Clin Nephrol 77(4):267–274
Shu KH, Chang CS, Chuang YW, Chen CH, Cheng CH, Wu MJ, Yu TM (2009) Intestinal bacterial overgrowth in CAPD patients with hypokalaemia. Nephrol Dial Transplant 24(4):1289–1292. doi:10.1093/ndt/gfn617
Afsar B, Elsurer R, Bilgic A, Sezer S, Ozdemir F (2010) Regular lactulose use is associated with lower peritonitis rates: an observational study. Perit Dial Int 30(2):243–246. doi:10.3747/pdi.2009.00035
Yildiz N, Turhan P, Bilgic O, Erguven M, Candan C (2010) Vaginal dialysate leakage in a child on peritoneal dialysis. Perit Dial Int 30(6):666–667. doi:10.3747/pdi.2009.00205
Paudel K, Namagondlu G, Samad N, McKitty K, Fan SL (2015) Lack of motivation: a new modifiable risk factor for peritonitis in patients undergoing peritoneal dialysis? J Ren Care 41(1):33–42. doi:10.1111/jorc.12101
Satomura A, Yanai M, Fujita T, Arashima Y, Kumasaka K, Nakane C, Ito K, Fuke Y, Maruyama T, Maruyama N, Okada K, Nakayama T, Matsumoto K (2010) Peritonitis associated with Pasteurella multocida: molecular evidence of zoonotic etiology. Ther Apher Dial 14(3):373–376. doi:10.1111/j.1744-9987.2009.00788.x
Broughton A, Verger C, Goffin E (2010) Pets-related peritonitis in peritoneal dialysis: companion animals or trojan horses? Semin Dial 23(3):306–316. doi:10.1111/j.1525-139X.2010.00726.x
Rudnicki M, Kerschbaum J, Hausdorfer J, Mayer G, Konig P (2010) Risk factors for peritoneal dialysis-associated peritonitis: the role of oral active vitamin d. Perit Dial Int 30(5):541–548. doi:10.3747/pdi.2009.00108
Kerschbaum J, Vychytil A, Lhotta K, Prischl FC, Wiesholzer M, Machhold-Fabrizii V, Kopriva-Altfahrt G, Schwarz C, Balcke P, Oberbauer R, Kramar R, Konig P, Rudnicki M (2013) Treatment with oral active vitamin D is associated with decreased risk of peritonitis and improved survival in patients on peritoneal dialysis. PLoS ONE 8(7):e67836. doi:10.1371/journal.pone.0067836
Qamar M, Sheth H, Bender FH, Piraino B (2009) Clinical outcomes in peritoneal dialysis: impact of continuous quality provement initiatives. Adv Perit Dial Conf Perit Dial 25:76–79
Iyer RN, Reddy AK, Gande S, Aiyangar A (2014) Evaluation of different culture methods for the diagnosis of peritonitis in patients on continuous ambulatory peritoneal dialysis. Clin Microbiol Infect 20(5):O294–296. doi:10.1111/1469-0691.12402
Barretti P, Doles JV, Pinotti DG, El Dib R (2014) Efficacy of antibiotic therapy for peritoneal dialysis-associated peritonitis: a proportional meta-analysis. BMC Infect Dis 14:445. doi:10.1186/1471-2334-14-445
Ruger W, van Ittersum FJ, Comazzetto LF, Hoeks SE, ter Wee PM (2011) Similar peritonitis outcome in CAPD and APD patients with dialysis modality continuation during peritonitis. Perit Dial Int 31(1):39–47. doi:10.3747/pdi.2009.00235
Chow KM, Szeto CC, Kwan BC, Pang WF, Ma T, Leung CB, Law MC, Li PK (2014) Randomized controlled study of icodextrin on the treatment of peritoneal dialysis patients during acute peritonitis. Nephrol Dial Transplant 29(7):1438–1443. doi:10.1093/ndt/gfu033
Liakopoulos V, Stefanidis I, Dombros NV (2010) Peritoneal dialysis glossary 2009. Int Urol Nephrol 42(2):417–423. doi:10.1007/s11255-009-9619-9
Szeto CC, Lai KB, Kwan BC, Chow KM, Leung CB, Law MC, Yu V, Li PK (2013) Bacteria-derived DNA fragment in peritoneal dialysis effluent as a predictor of relapsing peritonitis. Clin J Am Soc Nephrol 8(11):1935–1941. doi:10.2215/CJN.02360213
Fan S, Lane C, Punzalan S (2010) Correlation of periscreen strip results and white cell count in peritoneal dialysis peritonitis. J Ren Care 36(2):90–95. doi:10.1111/j.1755-6686.2010.00150.x
Kitterer D, Latus J, Pohlmann C, Alscher MD, Kimmel M (2015) Microbiological surveillance of peritoneal dialysis associated peritonitis: antimicrobial susceptibility profiles of a referral center in GERMANY over 32 years. PLoS ONE 10(9):e0135969. doi:10.1371/journal.pone.0135969
Sutherland SM, Alexander SR, Feneberg R, Schaefer F, Warady BA, International Pediatric Peritonitis R (2010) Enterococcal peritonitis in children receiving chronic peritoneal dialysis. Nephrol Dial Transplant 25(12):4048–4054. doi:10.1093/ndt/gfq295
Gilmore JF, Kim M, LaSalvia MT, Mahoney MV (2013) Treatment of enterococcal peritonitis with intraperitoneal daptomycin in a vancomycin-allergic patient and a review of the literature. Perit Dial Int 33(4):353–357. doi:10.3747/pdi.2012.00277
O’Shea S, Hawley CM, McDonald SP, Brown FG, Rosman JB, Wiggins KJ, Bannister KM, Johnson DW (2009) Streptococcal peritonitis in Australian peritoneal dialysis patients: predictors, treatment and outcomes in 287 cases. BMC Nephrol 10:19. doi:10.1186/1471-2369-10-19
Chao CT, Lee SY, Yang WS, Chen HW, Fang CC, Yen CJ, Chiang CK, Hung KY, Huang JW (2015) Viridans streptococci in peritoneal dialysis peritonitis: clinical courses and long-term outcomes. Perit Dial Int 35(3):333–341. doi:10.3747/pdi.2013.00108
Barretti P, Moraes TM, Camargo CH, Caramori JC, Mondelli AL, Montelli AC, da Cunha Mde L (2012) Peritoneal dialysis-related peritonitis due to Staphylococcus aureus: a single-center experience over 15 years. PLoS ONE 7(2):e31780. doi:10.1371/journal.pone.0031780
Lin SY, Ho MW, Liu JH, Liu YL, Yeh HC, Hsieh TL, Wang IK, Lin HH, Huang CC (2011) Successful salvage of peritoneal catheter in unresolved methicillin-resistant staphylococcus aureus peritonitis by combination treatment with daptomycin and rifampin. Blood Purif 32(4):249–252. doi:10.1159/000328028
Zhang W, Wu YG, Qi XM, Dai H, Lu W, Zhao M (2014) Peritoneal dialysis-related peritonitis with Acinetobacter baumannii: a review of seven cases. Perit Dial Int 34(3):317–321. doi:10.3747/pdi.2012.00198
Liakopoulos V, Arampatzis S, Kourti P, Tsolkas T, Zarogiannis S, Eleftheriadis T, Giannopoulou M, Stefanidis I (2011) Aeromonas hydrophila as a causative organism in peritoneal dialysis-related peritonitis: case report and review of the literature. Clin Nephrol 75(S1):65–68. doi:10.2379/CNP75065
Basturk T, Koc Y, Unsal A, Ahbap E, Sakaci T, Yildiz I, Kayabasi H, Sevinc M, Kose S, Arar A (2012) Fungal peritonitis in peritoneal dialysis: a 10 year retrospective analysis in a single center. Eur Rev Med Pharmacol Sci 16(12):1696–1700
Nadeau JH (2015) A pre-modern and post-modern perspective of epigenetic inheritance. Semin Cell Dev Biol 43:65. doi:10.1016/j.semcdb.2015.10.006
Levallois J, Nadeau-Fredette AC, Labbe AC, Laverdiere M, Ouimet D, Vallee M (2012) Ten-year experience with fungal peritonitis in peritoneal dialysis patients: antifungal susceptibility patterns in a North-American center. Int J Infect Dis (IJID) 16(1):e41–43. doi:10.1016/j.ijid.2011.09.016
Bhowmik D, Mahajan S, Bora M (2011) Concerns regarding the ISPD guidelines/recommendations for peritonitis due to mycobacteria. Perit Dial Int 31(3):363–364. doi:10.3747/pdi.2010.00292 Author reply 365
Ram R, Swarnalatha G, Akpolat T, Dakshinamurty KV (2013) Mycobacterium tuberculous peritonitis in CAPD patients: a report of 11 patients and review of literature. Int Urol Nephrol 45(4):1129–1135. doi:10.1007/s11255-012-0311-0
Renaud CJ, Subramanian S, Tambyah PA, Lee EJ (2011) The clinical course of rapidly growing nontuberculous mycobacterial peritoneal dialysis infections in Asians: a case series and literature review. Nephrology (Carlton) 16(2):174–179. doi:10.1111/j.1440-1797.2010.01370.x
Jiang SH, Roberts DM, Dawson AH, Jardine M (2012) Mycobacterium fortuitum as a cause of peritoneal dialysis-associated peritonitis: case report and review of the literature. BMC Nephrol 13:35. doi:10.1186/1471-2369-13-35
Jiang SH, Roberts DM, Clayton PA, Jardine M (2013) Non-tuberculous mycobacterial PD peritonitis in Australia. Int Urol Nephrol 45(5):1423–1428. doi:10.1007/s11255-012-0328-4
Song Y, Wu J, Yan H, Chen J (2012) Peritoneal dialysis-associated nontuberculous mycobacterium peritonitis: a systematic review of reported cases. Nephrol Dial Transplant 27(4):1639–1644. doi:10.1093/ndt/gfr504
Ram R, Swarnalatha G, Dakshinamurty KV (2014) Reinitiation of peritoneal dialysis after catheter removal for refractory peritonitis. J Nephrol 27(4):445–449. doi:10.1007/s40620-014-0048-1
Cho Y, Badve SV, Hawley CM, McDonald SP, Brown FG, Boudville N, Clayton P, Johnson DW (2014) Peritoneal dialysis outcomes after temporary haemodialysis transfer for peritonitis. Nephrol Dial Transplant 29(10):1940–1947. doi:10.1093/ndt/gfu050
Szeto CC, Kwan BC, Chow KM, Pang WF, Kwong VW, Leung CB, Li PK (2011) Persistent symptomatic intra-abdominal collection after catheter removal for PD-related peritonitis. Perit Dial Int 31(1):34–38. doi:10.3747/pdi.2009.00185
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All authors declare that they have no conflict of interest.
Ethical approval
This article does not contain any studies with human participants performed by any of the authors.
Rights and permissions
About this article
Cite this article
Liakopoulos, V., Nikitidou, O., Kalathas, T. et al. Peritoneal dialysis-related infections recommendations: 2016 update. What is new?. Int Urol Nephrol 49, 2177–2184 (2017). https://doi.org/10.1007/s11255-017-1632-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-017-1632-9