Outcomes of acinetobacter peritonitis in peritoneal dialysis patients: a multicenter registry analysis

Htay Htay, Yeoungjee Cho, Elaine M Pascoe, Carmel M Hawley, Philip A Clayton, Monique Borlace, Sunil V Badve, Kamal Sud, Neil C Boudville, Stephen P McDonald, David W Johnson

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Acinetobacteris a rare but important cause of peritonitis in peritoneal dialysis (PD) patients. As the complication has not been comprehensively evaluated previously, the present study examined the outcomes of Acinetobacter peritonitis in a large, national cohort of PD patients.

Methods: The study included all episodes of peritonitis in Australia from January 2004 to December 2014 using Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data. The primary outcome was peritonitis cure and secondary outcomes were catheter removal, hemodialysis transfer, recurrent/relapsing peritonitis, peritonitis-related hospitalization, and death. Outcomes were compared using multivariable logistic regression.

Results: Overall, 5,367 patients experienced 11,122 episodes of peritonitis across 51 centers in Australia. Of these, 228 (4.2%) patients experienced 253 (2.3%) episodes of Acinetobacter peritonitis (176 episodes were due to Acinetobacter alone and 77 involved co-infection with other organisms). Of the 176 solitary Acinetobacter episodes, 131(74%) achieved cure with antibiotics alone. Compared with Acinetobacter, significantly lower odds of peritonitis cure were observed for Pseudomonas (adjusted odds ratio [AOR] 0.24, 95% confidence interval [CI]: 0.16 - 0.36), other gram-negative organisms (AOR 0.54, 95% CI 0.37 - 0.77), fungi (AOR 0.02, 95% CI 0.01 - 0.03), and polymicrobial organisms (AOR 0.36, 95% CI 0.25 - 0.51), whilst similar odds of cure were observed for Staphylococcus (AOR 0.73, 95% CI 0.50 - 1.06), other gram-positive organisms (AOR 1.32,95% CI 0.93 - 1.89), culture-negative (AOR 1.19, 95% CI 0.82 -1.71), and other organisms (AOR 0.72, 95% CI 0.49 - 1.07). The odds of catheter removal and hemodialysis transfer were higher with Pseudomonas, other gram-negative, fungal, and polymicrobial peritonitis than with Acinetobacter peritonitis. The odds of death were also higher with Pseudomonas and fungal peritonitis than with Acinetobacter peritonitis. Treatment of Acinetobacter peritonitis with gentamicin, ciprofloxacin, or ceftazidime achieved comparable outcomes.

Conclusions: Outcomes of Acinetobacter peritonitis were favorable compared with most other forms of organism-specific peritonitis. Commonly used antibiotics covering gram-negative bacteria achieved comparable outcomes in Acinetobacter peritonitis.

Original languageEnglish
Pages (from-to)257-265
JournalPeritoneal Dialysis International
Volume38
Issue number4
Early online date7 Feb 2018
DOIs
Publication statusPublished - Jul 2018

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Acinetobacter
Peritoneal Dialysis
Peritonitis
Registries
Odds Ratio
Confidence Intervals
Pseudomonas
Renal Dialysis
Catheters
Organism Forms
Anti-Bacterial Agents
Ceftazidime
Ciprofloxacin

Cite this

Htay, H., Cho, Y., Pascoe, E. M., Hawley, C. M., Clayton, P. A., Borlace, M., ... Johnson, D. W. (2018). Outcomes of acinetobacter peritonitis in peritoneal dialysis patients: a multicenter registry analysis. Peritoneal Dialysis International, 38(4), 257-265. https://doi.org/10.3747/pdi.2017.00199
Htay, Htay ; Cho, Yeoungjee ; Pascoe, Elaine M ; Hawley, Carmel M ; Clayton, Philip A ; Borlace, Monique ; Badve, Sunil V ; Sud, Kamal ; Boudville, Neil C ; McDonald, Stephen P ; Johnson, David W. / Outcomes of acinetobacter peritonitis in peritoneal dialysis patients : a multicenter registry analysis. In: Peritoneal Dialysis International. 2018 ; Vol. 38, No. 4. pp. 257-265.
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abstract = "Background: Acinetobacteris a rare but important cause of peritonitis in peritoneal dialysis (PD) patients. As the complication has not been comprehensively evaluated previously, the present study examined the outcomes of Acinetobacter peritonitis in a large, national cohort of PD patients.Methods: The study included all episodes of peritonitis in Australia from January 2004 to December 2014 using Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data. The primary outcome was peritonitis cure and secondary outcomes were catheter removal, hemodialysis transfer, recurrent/relapsing peritonitis, peritonitis-related hospitalization, and death. Outcomes were compared using multivariable logistic regression.Results: Overall, 5,367 patients experienced 11,122 episodes of peritonitis across 51 centers in Australia. Of these, 228 (4.2{\%}) patients experienced 253 (2.3{\%}) episodes of Acinetobacter peritonitis (176 episodes were due to Acinetobacter alone and 77 involved co-infection with other organisms). Of the 176 solitary Acinetobacter episodes, 131(74{\%}) achieved cure with antibiotics alone. Compared with Acinetobacter, significantly lower odds of peritonitis cure were observed for Pseudomonas (adjusted odds ratio [AOR] 0.24, 95{\%} confidence interval [CI]: 0.16 - 0.36), other gram-negative organisms (AOR 0.54, 95{\%} CI 0.37 - 0.77), fungi (AOR 0.02, 95{\%} CI 0.01 - 0.03), and polymicrobial organisms (AOR 0.36, 95{\%} CI 0.25 - 0.51), whilst similar odds of cure were observed for Staphylococcus (AOR 0.73, 95{\%} CI 0.50 - 1.06), other gram-positive organisms (AOR 1.32,95{\%} CI 0.93 - 1.89), culture-negative (AOR 1.19, 95{\%} CI 0.82 -1.71), and other organisms (AOR 0.72, 95{\%} CI 0.49 - 1.07). The odds of catheter removal and hemodialysis transfer were higher with Pseudomonas, other gram-negative, fungal, and polymicrobial peritonitis than with Acinetobacter peritonitis. The odds of death were also higher with Pseudomonas and fungal peritonitis than with Acinetobacter peritonitis. Treatment of Acinetobacter peritonitis with gentamicin, ciprofloxacin, or ceftazidime achieved comparable outcomes.Conclusions: Outcomes of Acinetobacter peritonitis were favorable compared with most other forms of organism-specific peritonitis. Commonly used antibiotics covering gram-negative bacteria achieved comparable outcomes in Acinetobacter peritonitis.",
author = "Htay Htay and Yeoungjee Cho and Pascoe, {Elaine M} and Hawley, {Carmel M} and Clayton, {Philip A} and Monique Borlace and Badve, {Sunil V} and Kamal Sud and Boudville, {Neil C} and McDonald, {Stephen P} and Johnson, {David W}",
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Htay, H, Cho, Y, Pascoe, EM, Hawley, CM, Clayton, PA, Borlace, M, Badve, SV, Sud, K, Boudville, NC, McDonald, SP & Johnson, DW 2018, 'Outcomes of acinetobacter peritonitis in peritoneal dialysis patients: a multicenter registry analysis' Peritoneal Dialysis International, vol. 38, no. 4, pp. 257-265. https://doi.org/10.3747/pdi.2017.00199

Outcomes of acinetobacter peritonitis in peritoneal dialysis patients : a multicenter registry analysis. / Htay, Htay; Cho, Yeoungjee; Pascoe, Elaine M; Hawley, Carmel M; Clayton, Philip A; Borlace, Monique; Badve, Sunil V; Sud, Kamal; Boudville, Neil C; McDonald, Stephen P; Johnson, David W.

In: Peritoneal Dialysis International, Vol. 38, No. 4, 07.2018, p. 257-265.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Outcomes of acinetobacter peritonitis in peritoneal dialysis patients

T2 - a multicenter registry analysis

AU - Htay, Htay

AU - Cho, Yeoungjee

AU - Pascoe, Elaine M

AU - Hawley, Carmel M

AU - Clayton, Philip A

AU - Borlace, Monique

AU - Badve, Sunil V

AU - Sud, Kamal

AU - Boudville, Neil C

AU - McDonald, Stephen P

AU - Johnson, David W

PY - 2018/7

Y1 - 2018/7

N2 - Background: Acinetobacteris a rare but important cause of peritonitis in peritoneal dialysis (PD) patients. As the complication has not been comprehensively evaluated previously, the present study examined the outcomes of Acinetobacter peritonitis in a large, national cohort of PD patients.Methods: The study included all episodes of peritonitis in Australia from January 2004 to December 2014 using Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data. The primary outcome was peritonitis cure and secondary outcomes were catheter removal, hemodialysis transfer, recurrent/relapsing peritonitis, peritonitis-related hospitalization, and death. Outcomes were compared using multivariable logistic regression.Results: Overall, 5,367 patients experienced 11,122 episodes of peritonitis across 51 centers in Australia. Of these, 228 (4.2%) patients experienced 253 (2.3%) episodes of Acinetobacter peritonitis (176 episodes were due to Acinetobacter alone and 77 involved co-infection with other organisms). Of the 176 solitary Acinetobacter episodes, 131(74%) achieved cure with antibiotics alone. Compared with Acinetobacter, significantly lower odds of peritonitis cure were observed for Pseudomonas (adjusted odds ratio [AOR] 0.24, 95% confidence interval [CI]: 0.16 - 0.36), other gram-negative organisms (AOR 0.54, 95% CI 0.37 - 0.77), fungi (AOR 0.02, 95% CI 0.01 - 0.03), and polymicrobial organisms (AOR 0.36, 95% CI 0.25 - 0.51), whilst similar odds of cure were observed for Staphylococcus (AOR 0.73, 95% CI 0.50 - 1.06), other gram-positive organisms (AOR 1.32,95% CI 0.93 - 1.89), culture-negative (AOR 1.19, 95% CI 0.82 -1.71), and other organisms (AOR 0.72, 95% CI 0.49 - 1.07). The odds of catheter removal and hemodialysis transfer were higher with Pseudomonas, other gram-negative, fungal, and polymicrobial peritonitis than with Acinetobacter peritonitis. The odds of death were also higher with Pseudomonas and fungal peritonitis than with Acinetobacter peritonitis. Treatment of Acinetobacter peritonitis with gentamicin, ciprofloxacin, or ceftazidime achieved comparable outcomes.Conclusions: Outcomes of Acinetobacter peritonitis were favorable compared with most other forms of organism-specific peritonitis. Commonly used antibiotics covering gram-negative bacteria achieved comparable outcomes in Acinetobacter peritonitis.

AB - Background: Acinetobacteris a rare but important cause of peritonitis in peritoneal dialysis (PD) patients. As the complication has not been comprehensively evaluated previously, the present study examined the outcomes of Acinetobacter peritonitis in a large, national cohort of PD patients.Methods: The study included all episodes of peritonitis in Australia from January 2004 to December 2014 using Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data. The primary outcome was peritonitis cure and secondary outcomes were catheter removal, hemodialysis transfer, recurrent/relapsing peritonitis, peritonitis-related hospitalization, and death. Outcomes were compared using multivariable logistic regression.Results: Overall, 5,367 patients experienced 11,122 episodes of peritonitis across 51 centers in Australia. Of these, 228 (4.2%) patients experienced 253 (2.3%) episodes of Acinetobacter peritonitis (176 episodes were due to Acinetobacter alone and 77 involved co-infection with other organisms). Of the 176 solitary Acinetobacter episodes, 131(74%) achieved cure with antibiotics alone. Compared with Acinetobacter, significantly lower odds of peritonitis cure were observed for Pseudomonas (adjusted odds ratio [AOR] 0.24, 95% confidence interval [CI]: 0.16 - 0.36), other gram-negative organisms (AOR 0.54, 95% CI 0.37 - 0.77), fungi (AOR 0.02, 95% CI 0.01 - 0.03), and polymicrobial organisms (AOR 0.36, 95% CI 0.25 - 0.51), whilst similar odds of cure were observed for Staphylococcus (AOR 0.73, 95% CI 0.50 - 1.06), other gram-positive organisms (AOR 1.32,95% CI 0.93 - 1.89), culture-negative (AOR 1.19, 95% CI 0.82 -1.71), and other organisms (AOR 0.72, 95% CI 0.49 - 1.07). The odds of catheter removal and hemodialysis transfer were higher with Pseudomonas, other gram-negative, fungal, and polymicrobial peritonitis than with Acinetobacter peritonitis. The odds of death were also higher with Pseudomonas and fungal peritonitis than with Acinetobacter peritonitis. Treatment of Acinetobacter peritonitis with gentamicin, ciprofloxacin, or ceftazidime achieved comparable outcomes.Conclusions: Outcomes of Acinetobacter peritonitis were favorable compared with most other forms of organism-specific peritonitis. Commonly used antibiotics covering gram-negative bacteria achieved comparable outcomes in Acinetobacter peritonitis.

U2 - 10.3747/pdi.2017.00199

DO - 10.3747/pdi.2017.00199

M3 - Article

VL - 38

SP - 257

EP - 265

JO - Peritoneal Dialysis International

JF - Peritoneal Dialysis International

SN - 0896-8608

IS - 4

ER -