Effects of climatic region on peritonitis risk, microbiology, treatment, and outcomes: a multicenter registry study

Cho, Yeoungjee, Badve, Sunil V., Hawley, Carmel M., McDonald, Stephen P., Brown, Fiona G., Boudville, Neil, Wiggins, Kathryn J., Bannister, Kym M., Clayton, Philip and Johnson, David W. (2013) Effects of climatic region on peritonitis risk, microbiology, treatment, and outcomes: a multicenter registry study. Peritoneal Dialysis International, 33 1: 75-85. doi:10.3747/pdi.2011.00317

Author Cho, Yeoungjee
Badve, Sunil V.
Hawley, Carmel M.
McDonald, Stephen P.
Brown, Fiona G.
Boudville, Neil
Wiggins, Kathryn J.
Bannister, Kym M.
Clayton, Philip
Johnson, David W.
Title Effects of climatic region on peritonitis risk, microbiology, treatment, and outcomes: a multicenter registry study
Journal name Peritoneal Dialysis International   Check publisher's open access policy
ISSN 0896-8608
Publication date 2013-01
Year available 2012
Sub-type Article (original research)
DOI 10.3747/pdi.2011.00317
Open Access Status DOI
Volume 33
Issue 1
Start page 75
End page 85
Total pages 11
Place of publication Milton, ON, Canada
Publisher Multimed
Collection year 2013
Language eng
Formatted abstract
Background: The impact of climatic variations on peritoneal dialysis (PD)-related peritonitis has not been studied in detail. The aim of the current study was to determine whether various climatic zones influenced the probability of occurrence or the clinical outcomes of peritonitis.

Methods: Using ANZDATA registry data, the study in cluded all Australian patients receiving PD between 1 October 2003 and 31 December 2008. Climatic regions were defined according to the Köppen classification.

Results: The overall peritonitis rate was 0.59 episodes per patient-year. Most of the patients lived in Temperate regions (65%), with others residing in Subtropical (26%), Tropical (6%), and Other climatic regions (Desert, 0.6%; Grassland, 2.3%). Compared with patients in Temperate regions, those in Tropical regions demonstrated significantly higher overall peritonitis rates and a shorter time to a first peritonitis episode [adjusted hazard ratio: 1.15; 95% confidence interval (CI): 1.01 to 1.31]. Culture-negative peritonitis was significantly less likely in Tropical regions [adjusted odds ratio (OR): 0.42; 95% CI: 0.25 to 0.73]; its occurrence in Subtropical and Other regions was comparable to that in Temperate regions. Fungal peritonitis was independently associated with Tropical regions (OR: 2.18; 95% CI: 1.22 to 3.90) and Other regions (OR: 3.46; 95% CI: 1.73 to 6.91), where rates of antifungal prophylaxis were also lower. Outcomes after first peritonitis episodes were comparable in all groups.

Conclusions: Tropical regions were associated with a higher overall peritonitis rate (including fungal peritonitis) and a shorter time to a first peritonitis episode. Augmented peritonitis prophylactic measures such as antifungal therapy and exit-site care should be considered in PD patients residing in Tropical climates.
Keyword Antibiotics
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes epub ahead of print: 1 September 2012.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
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