Using culture-independent microbiology techniques to elucidate diagnostic complexity in peritoneal dialysis-associated peritonitis

Peritoneal dialysis-associated peritonitis is a life-threatening complication for patients undergoing renal replacement therapy using peritoneal dialysis. Poor outcomes for peritoneal dialysis patients are driven by the unacceptably high risk of morbidity and mortality associated with peritonitis: dialysis technique failure and patient death are a common outcome from a peritonitis episode. The application of rapid diagnostic techniques, and deeper understanding of host-microbial interactions during early infection are key to improving patient outcomes. This thesis develops and applies a range of rapid, culture-independent microbiology tools to predict infection, assay antimicrobial susceptibility, and better understand the diagnostic challenges of peritoneal dialysis-associated peritonitis.