RESUMO
102 episodes of continuous ambulatory peritoneal dialysis (CAPD) peritonitis were studied prospectively during a 288-day period at The Queen Elizabeth Hospital, Birmingham. Organisms were isolated from 76% of the episodes, with coagulase-negative staphylococci, being the most commonly encountered organism (55%). Initial treatment consisted of intraperitoneal vancomycin and ceftazidime with subsequent adjustment on the basis of antibiotic sensitivities. With this regimen, 83% of the positive cultures became negative by 72 h, 9.8% of cases relapsed and removal of the CAPD catheter was necessary in 8 patients (7.8%). Overall, 92% of cases were cured. No adverse drug reactions were seen. This combination of antibiotics appears effective and safe in the treatment of CAPD peritonitis.
Assuntos
Ceftazidima/administração & dosagem , Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Peritonite/tratamento farmacológico , Vancomicina/administração & dosagem , Adolescente , Adulto , Idoso , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peritonite/etiologiaRESUMO
Two patients previously managed by continuous ambulatory peritoneal dialysis for end stage renal failure received cadaveric renal transplants. The peritoneal catheter was capped off and left in situ postoperatively. Both patients developed bacterial peritonitis shortly after transplantation. It was felt that the infections were associated with the presence of the indwelling peritoneal catheter as there was no clinical evidence of peritonitis at the time of transplantation.
Assuntos
Infecções Bacterianas/etiologia , Transplante de Rim , Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Peritonite/etiologia , Complicações Pós-Operatórias/etiologia , Aeromonas , Cateteres de Demora , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Estafilocócicas/etiologiaRESUMO
Continuous ambulatory peritoneal dialysis (CAPD) is of proven value in the treatment of many patients with chronic renal failure. Infective peritonitis remains the major complication of this form of therapy and repeated infections may result in catheter removal and conversion to haemodialysis. The most appropriate antibiotic treatment, the duration and route of administration are still areas of investigation. The aim of this paper is to discuss the diagnosis, management and prevention of peritonitis in CAPD.
Assuntos
Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Peritonite/etiologia , Humanos , Peritonite/diagnóstico , Peritonite/terapiaRESUMO
The introduction and use of a multipoint inoculation identification scheme in a diagnostic laboratory processing approximately 60,000 specimens per years is described.
Assuntos
Técnicas Bacteriológicas , Bactérias Gram-Negativas/isolamento & purificação , Meios de Cultura , Humanos , Testes de Sensibilidade MicrobianaRESUMO
Mid stream specimens of urine that showed pyuria or bacteriuria on direct microscopy and no bacterial growth on initial routine culture were collected from 346 patients. These specimens were cultured for the presence of fastidious organisms using two different test systems. One system used non selective media and the other used selective media. Any fastidious organism isolated was identified by standard methods. Lactobacilli were the only fastidious organisms isolated in significant numbers. Using comparable test systems, equivalent numbers of Lactobacilli were isolated from both test and control group and because of the difficulty in specimen collection, these are to be considered as possible contaminants.
