Microbiology and Antimicrobial Resistance Profile of Infectious Peritonitis: A Cohort Study with 10-year Follow-up

Abstract

Abstract Objectives: Peritoneal dialysis (PD) is a feasible option for patients with renal failure, but infectious peritonitis has long been a common complication in PD. The purpose of the current study was to provide epidemiological data about the rate, microbiology profile, and antimicrobial susceptibility pattern of infectious peritonitis in adult PD patients in Saudi Arabia. Materials and Methods: A descriptive study was performed. Demographics and diagnostic data of adult PD patients between 2009 and 2019 were collected. The infectious peritonitis episodes were explained per patient and the microbiology profile along with antimicrobial susceptibility testing results were analyzed. Results: One hundred renal failure adult patients underwent PD during 2009–2019, with 55.0% were female. Ninety-three infectious peritonitis episodes were identified in 52 patients and the overall peritonitis rate was 0.56 episodes per patient-year. Gram-positive bacteria were more responsible (61.3%) for infectious peritonitis than Gram-negative bacteria (37.6%) and expressed more antimicrobial resistance patterns. Coagulase-negative Staphylococci were the most frequently isolated Gram-positive bacteria from the PD fluid culture (27.9%). Acinetobacter baumannii, followed by Pseudomonas luteola, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the most common Gram-negative bacteria identified at 6.5%, 5.4%, 5.4%, and 5.4%, respectively, with susceptibility patterns detected against most of the antimicrobials tested. Conclusions: The overall rate of infectious peritonitis was 0.56 episodes per patient-year, which is higher than the reported target published by the International Society for PD. More intense training programs and establishment of a national infectious peritonitis registry are recommended to minimize infection risk and improve patients’ quality of life.