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Clinical and microbiological characteristics of peritoneal dialysis-related peritonitis caused by Escherichia coli in southern Taiwan

  • Wei-Hung Lin
  • Chin-Chung Tseng
  • An-Bang Wu
  • Yu-Tzu Chang
  • Te-Hui Kuo
  • Jo-Yen Chao
  • Ming-Cheng Wang
  • Jiunn-Jong Wu
Original Article
  • 108 Downloads

Abstract

Peritonitis is a serious complication and major cause of treatment failure in patients undergoing peritoneal dialysis (PD). Escherichia coli is the major pathogen in extraintestinal Gram-negative infections, including PD-related peritonitis. The outcomes of E. coli peritonitis in PD varied from relatively favorable outcomes to a higher incidence of treatment failure. The aim of this study was to investigate the impact of bacterial virulence and host characteristics on the outcomes of PD-related peritonitis caused by E. coli. From January 2000 to June 2016, a total of 47 episodes of monomicrobial and 10 episodes of polymicrobial E. coli PD-related peritonitis, as well as 89 episodes of monomicrobial Gram-positive (56 Staphylococcus spp. and 33 Streptococcus spp.) PD-related peritonitis cases, were retrospectively enrolled. Clinical features, E. coli bacterial virulence, and outcomes were analyzed. Compared to Streptococcus spp. peritonitis, E. coli peritonitis had a higher peritoneal catheter removal rate (38 versus 12%; P = 0.0115). Compared to the monomicrobial group, patients in polymicrobial group were older and had higher peritoneal catheter removal rate (80 versus 38%; P = 0.0324). Treatment failure of E. coli peritonitis was associated with more polymicrobial peritonitis and immunocompromised comorbidity, longer duration of PD therapy, and more antimicrobial resistance. E. coli isolates with more iron-related genes had higher prevalence of phylogenetic group B2 and papG II, iha, ompT, and usp genes. This study demonstrates the important roles of clinical and bacterial characteristics in the outcomes of monomicrobial and polymicrobial E. coli PD-related peritonitis.

Keywords

Escherichia coli Peritoneal dialysis Peritonitis Virulence 

Notes

Acknowledgements

We would like to thank all the technical staff at the Division of Nephrology at the National Cheng Kung University Hospital.

Funding

This work was supported partially by grants from NCKUH-10702019 and Ministry of Science and Technology, Taiwan (MOST) (102-2314-B-006-015).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required.

Informed consent

No identifying information is included.

Supplementary material

10096_2018_3302_MOESM1_ESM.docx (20 kb)
ESM 1 (DOCX 19 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Wei-Hung Lin
    • 1
    • 2
  • Chin-Chung Tseng
    • 3
  • An-Bang Wu
    • 3
  • Yu-Tzu Chang
    • 3
  • Te-Hui Kuo
    • 3
  • Jo-Yen Chao
    • 3
  • Ming-Cheng Wang
    • 3
    • 4
  • Jiunn-Jong Wu
    • 5
  1. 1.Department of Internal MedicineNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
  2. 2.Institute of Clinical Medicine, College of MedicineNational Cheng Kung UniversityTainanTaiwan
  3. 3.Division of Nephrology, Department of Internal MedicineNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
  4. 4.Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of MedicineNational Cheng Kung UniversityTainanTaiwan
  5. 5.Department of Biotechnology and Laboratory Science in Medicine, School of Biomedical Science and EngineeringNational Yang Ming UniversityTaipeiTaiwan

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