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BMC Nephrology
Published in: BMC Nephrology 1/2023

Open Access 01-12-2023 | Peritonitis | Research

Comparison of clinical outcomes between culture-negative and positive peritonitis in patients undergoing maintenance peritoneal dialysis: a prospective cohort study

Authors: Kittiphan Chienwichai, Sorawat Sangaew, Laksamee Chuachanpipat, Arunchai Chang

Published in: BMC Nephrology | Issue 1/2023

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Abstract

Background

Culture-negative peritonitis is a serious complication in patients undergoing maintenance peritoneal dialysis (PD) and occurs in up to 40% of all peritonitis episodes. Despite its high incidence, data regarding treatment response and prognosis remain poorly defined. This study compared the clinical outcomes of patients with culture-negative and positive peritonitis.

Method

This prospective cohort study was conducted between 2021 and 2022. Patients treated with maintenance PD who developed PD-associated peritonitis were included and received standard treatment. The primary endpoint was the primary response (resolution of peritonitis 10 days after the initiation of treatment).

Results

Of the 81 patients who developed PD-associated peritonitis during the study, 35 and 46 had culture-negative and culture-positive peritonitis, respectively. Overall, 52 (64.2%) patients achieved the primary response: 24 (68.6%) in the culture-negative group and 28 (60.9%) in the culture-positive group (p = 0.630). There were no significant differences between the two groups in the incidence of complete cure (complete resolution of peritonitis without the need for Tenckhoff catheter removal or salvage antibiotic therapy or peritonitis within 120 days after treatment) (culture-negative vs. culture-positive group, 57.1% vs. 45.7%), refractory peritonitis (28.6% vs. 41.3%), relapse peritonitis (8.6% vs. 2.2%), repeat peritonitis (11.4% vs. 10.9%), salvage antibiotics (40.0% vs. 50.0%), permanent hemodialysis transfer (11.4% vs. 10.9%), Tenckhoff catheter removal (25.7% vs. 41.3%), or mortality (2.9% vs. 2.2%) (all p > 0.05).

Conclusion

This study offers valuable insights into the clinical outcomes of culture-negative peritonitis versus culture-positive peritonitis. However, caution must be exercised in interpreting these findings due to the limitations of the small sample size.

Clinical trial registration

The study was retrospectively registered in the Thai Clinical Trials Registry (TCTR20221130006).
Appendix
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Metadata
Title
Comparison of clinical outcomes between culture-negative and positive peritonitis in patients undergoing maintenance peritoneal dialysis: a prospective cohort study
Authors
Kittiphan Chienwichai
Sorawat Sangaew
Laksamee Chuachanpipat
Arunchai Chang
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2023
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-023-03389-7

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