Pseudomonas Peritonitis in Australia: Predictors, Treatment, and Outcomes in 191 Cases

Siva, B., Hawley, C. M., McDonald, S. P., Brown, F. G., Rosman, J. B., Wiggins, K. J., Bannister, K. M. and Johnson, D. W. (2009) Pseudomonas Peritonitis in Australia: Predictors, Treatment, and Outcomes in 191 Cases. Clinical Journal of The American Society of Nephrology, 4 5: 957-964. doi:10.2215/CJN.00010109


Author Siva, B.
Hawley, C. M.
McDonald, S. P.
Brown, F. G.
Rosman, J. B.
Wiggins, K. J.
Bannister, K. M.
Johnson, D. W.
Title Pseudomonas Peritonitis in Australia: Predictors, Treatment, and Outcomes in 191 Cases
Formatted title
Pseudomonas Peritonitis in Australia: Predictors, Treatment, and Outcomes in 191 Cases
Journal name Clinical Journal of The American Society of Nephrology   Check publisher's open access policy
ISSN 1555-9041
Publication date 2009-01-01
Year available 2009
Sub-type Article (original research)
DOI 10.2215/CJN.00010109
Open Access Status DOI
Volume 4
Issue 5
Start page 957
End page 964
Total pages 8
Editor William M. Bennett
Place of publication United State
Publisher American Society of Nephrology
Language eng
Subject C1
920109 Infectious Diseases
110309 Infectious Diseases
Abstract Design, setting, participants, & measurements: The predictors, treatment, and clinical outcomes of Pseudomonas peritonitis were examined by binary logistic regression and multilevel, multivariate Poisson regression in all Australian PD patients in 66 centers between 2003 and 2006. Results: A total of 191 episodes of Pseudomonas peritonitis (5.3% of all peritonitis episodes) occurred in 171 individuals. Its occurrence was independently predicted by Maori/Pacific Islander race, Aboriginal/Torres Strait Islander race, and absence of baseline peritoneal equilibration test data. Compared with other organisms, Pseudomonas peritonitis was associated with greater frequencies of hospitalization (96 versus 79%; P = 0.006), catheter removal (44 versus 20%; P < 0.001), and permanent hemodialysis transfer (35 versus 17%; P < 0.001) but comparable death rates (3 versus 2%; P = 0.4). Initial empiric antibiotic choice did not influence outcomes, but subsequent use of dual anti-pseudomonal therapy was associated with a lower risk for permanent hemodialysis transfer (10 versus 38%, respectively; P = 0.03). Catheter removal was associated with a lower risk for death than treatment with antibiotics alone (0 versus 6%; P < 0.05). Conclusions: Pseudomonas peritonitis is associated with high rates of catheter removal and permanent hemodialysis transfer. Prompt catheter removal and use of two anti-pseudomonal antibiotics are associated with better outcomes.
Keyword DIALYSIS
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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Created: Thu, 03 Sep 2009, 18:11:57 EST by Mr Andrew Martlew on behalf of Medicine - Princess Alexandra Hospital