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A survey of peritonitis and exit-site and/or tunnel infections in Japanese children on PD

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Abstract

To obtain data on peritonitis and exit-site and/or tunnel infections (ESI/TI) in Japanese children undergoing peritoneal dialysis (PD) from January 1999 through June 2003, we surveyed 22 members of the Japanese Study Group of Pediatric Peritoneal Dialysis (JSPPD) by questionnaire. One hundred and thirty patients were eligible. Seventy episodes of bacterial peritonitis occurred in 45 patients (0.17 episodes/patient-year), and 123 ESI/TI occurred in 60 patients (0.29 episodes/patient-year). S. aureus and MRSA were found to be the causative organisms in 39% and 13% of the peritonitis episodes, and in 59% and 20% of the ESI/TI, respectively. Tunnel infection was found in 55% of the MRSA peritonitis episodes. Eleven percent of the peritonitis episodes relapsed, and 19% needed hemodialysis. One patient died due to MRSA peritonitis. The PD catheter was removed in all fungal and 78% of MRSA peritonitis. However, the type of organism did not influence the need for catheter-related surgery for ESI/TI. Neither peritonitis nor ESI/TI was prevented by the use of a swan-neck catheter, a downward-pointing exit site, povidone iodine exit-site care, bathing instruments, or nasal mupirocin. In conclusion, MRSA peritonitis was not uncommon in children in Japan, was frequently associated with tunnel infections, and had a poor outcome. No association was found between the occurrence of infection and preventive measures previously reported as effective. Alternative approaches are needed in children, especially for MRSA.

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Acknowledgement

The authors are most grateful for the review of this paper by Anders Tranaeus, M.D., Ph.D.

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Authors and Affiliations

  1. Department of Pediatrics, Nishi-Sapporo National Hospital, Yamanote 5–7, Nishiku, Sapporo, Hokkaido, 063-0001, Japan

    Sakurako Hoshii

  2. Department of Pediatric Nephrology, Shizuoka Children’s Hospital, Shizuoka, Japan

    Naohiro Wada

  3. Department of Pediatrics, Tokyo Metropolitan Children’s Hospital, Tokyo, Japan

    Masataka Honda

Authors
  1. Sakurako Hoshii
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  2. Naohiro Wada
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  3. Masataka Honda
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Consortia

Japanese Study Group of Pediatric Peritoneal Dialysis

Corresponding author

Correspondence to Sakurako Hoshii.

Additional information

Members of the Japanese Study Group of Pediatric Peritoneal Dialysis (JSPPD) that participated in this survey: Yuko Akioka (Chiba), Kazumoto Iijima (Tokyo), Masahiro Ikeda (Tokyo), Masaaki Ikoma (Kawasaki), Yuhei Ito (Kurume), Osamu Uemura (Ohbu), Yoshiyuki Ohtomo (Iwatsuki), Yoshitsugu Kaku (Fukuoka), Takashi Sakano (Hiroshima), Kenichi Satomura (Osaka), Junzo Suzuki (Fukushima), Eihiko Takahashi (Yokohama), Masafumi Taki (Okayama), Motoshi Hattori (Tokyo), Hitoshi Nakazato (Kumamoto), Shinya Nakamura (Sagamihara), Kandai Nozu (Kobe), Toshio Yanagihara (Niigata), Hiroshi Yoshimura (Uruma)

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Hoshii, S., Wada, N., Honda, M. et al. A survey of peritonitis and exit-site and/or tunnel infections in Japanese children on PD. Pediatr Nephrol 21, 828–834 (2006). https://doi.org/10.1007/s00467-006-0004-y

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  • DOI: https://doi.org/10.1007/s00467-006-0004-y

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