CAPD Fluid Examination using the Bactec 460

Abstract

In the microbiological laboratory CAPD fluid analysis is an unstandardized and sometimes a labor intensive procedure. This pilot study was set up to demonstrate the value of in-place technology -the Bactec 460 blood culture system, in reducing the work-load. Our results indicate that it is at least as effective as other, more tedious conventional methods. Since its introduction, continuous ambulatory peritoneal dialysis (CAPD) has proved to be a major advance in the management of end-stage renal disease (I). Despite refinements in technique over the years leading to more widespread use of CAPD, the major hazard remains peritonitis and other infections (2). Also peritonitis is a major cause of failure of CAPD (3,4). Because CAPD allows more freedom of movement, several laboratories receive the postdialysis effluents from the same patient; furthermore there is no widely recognized, single method for the examination of these fluids (2, 5). Some centers recommend daily sampling for microbiological studies and while this is ideal for patient management, it imposes a significant workload on the microbiology laboratory, particularly in a larger centre (2). Currently it appears that the number of patients on CAPD will continue to increase for the foreseeable future and so will the numbers of specimens to be examined. To facilitate these examinations, we carried out a five-month pilot study using the Bactec 460 blood-culture system to examine CAPD fluids. We compared these results with a conventional method used previously in our laboratory.