Microbiological Surveillance and Antimicrobial Susceptibility Observations on Peritoneal Dialysis-Associated Peritonitis in an Outpatient German Reference Center
Abstract
:1. Background
2. Materials and Methods
2.1. Data Collection
2.2. Diagnosis
2.3. Standardized Sample Handling
2.4. Evaluation of Microbial Spectrum and Resistance Profile
2.5. Treatment Regimens
2.6. Ethical Approval
2.7. Analysis
3. Results
3.1. Demographic and Clinical Characteristics
3.2. Distribution of Peritonitis Episodes
3.3. Spectrum of Causative Bacteria
3.4. Changes in the Pathogenic Spectrum over Time
3.5. Resistance Profiles
3.6. Multi-Drug-Resistant and Atypical Pathogens
Antibiotics | Microorganisms [s (r)] | ||||||||
---|---|---|---|---|---|---|---|---|---|
Staphylococcus aureus | Staphylococcus epidemidis | Streptococcus spp. | Enterococcus spp. | Enterobacter cloacae | Escherichia coli | Klebsiella spp. | Serratia marcescens | Acinetobacter spp. | |
Penicillines | |||||||||
Penicillin G | 2 (2) | 0 (3) | 3 (0) | NT | NT | NT | 0 (2) | NT | NT |
Ampicillin | 4 (3) | 1 (3) | 5 (0) | 1 (1) | 0 (1) | 0 (5) | 0 (1) | 0 (2) | 0 (2) |
Ampicillin/Sulbactam | 9 (0) | 4 (1) | 2 (0) | 1 (1) | 0 (1) | 2 (3) | 1 (0) | 0 (1) | 1 (0) |
Piperacillin/Tazobactam | 6 (0) | 3 (1) | 3 (0) | 1 (1) | 5 (0) | 3 (0) | 3 (0) | 0 (1) | 1 (0) |
Oxacillin | 9 (0) | 4 (1) | 1 (1) | NT | NT | NT | NT | 1 (1) | NT |
Cephalosporines | |||||||||
Cefazolin (1) 1 | 4 (0) | 3 (1) | 1 (0) | NT | NT | NT | NT | 0 (1) | NT |
Cefuroxim (2) 1 | 11 (0) | 6 (1) | 5 (0) | 0 (2) | NT | 3 (2) | NT | 0 (1) | 1 (0) |
Ceftriaxon (3a) 1 | 5 (0) | 3 (1) | 5 (0) | 0 (2) | 5 (0) | 2 (0) | 2 (0) | 0 (1) | 0 (1) |
Ceftazidim (3b) 1 | 2 (0) | 1 (1) | 3 (0) | 0 (1) | 5 (0) | 3 (1) | 3 (0) | 1 (1) | 1 (2) |
Cefepim (4) 1 | 1 (0) | 1 (1) | 1 (0) | NT | 4 (0) | NT | 2 (0) | 0 (1) | 0 (1) |
Carbapenemes | |||||||||
Imipinem | 6 (0) | 2 (1) | 2 (0) | 1 (1) | 1 (0) | 5 (0) | 1 (0) | 1 (1) | 2 (0) |
Meropenem | 8 (0) | 3 (1) | 2 (0) | 0 (1) | 5 (0) | 5 (0) | 3 (0) | 0 (1) | 3 (0) |
Chinolone | |||||||||
Ciprofloxacin | 7 (0) | 5 (1) | 2 (1) | 1 (0) | 5 (0) | 4 (1) | 3 (0) | 1 (0) | 3 (0) |
Levofloxacin | 10 (0) | 7 (0) | 6 (0) | 1 (0) | 5 (0) | 2 (1) | 2 (0) | 0 (1) | 2 (0) |
Glykopeptides | |||||||||
Vancomycin | 9 (0) | 5 (0) | 4 (0) | 2 (0) | NT | NT | NT | 1 (0) | NT |
Aminoglykosides | |||||||||
Gentamicin | 11 (1) | 7 (0) | 1 (2) | 1 (1) | 5 (0) | 5 (0) | 3 (0) | 1 (0) | 3 (0) |
Oxazolidinone | |||||||||
Linezolid | 8 (0) | 5 (0) | 2 (0) | 2 (0) | NT | NT | NT | NT | NT |
Total (n) 2 | 14 | 7 | 12 | 5 | 5 | 8 | 7 | 3 | 3 |
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
List of Abbreviations
APD | Automated peritoneal dialysis |
CAPD | Continuous ambulatory peritoneal dialysis |
ISPD | International Society for Peritoneal Dialysis |
IP | Intraperitoneal |
MRSA | Methicillin-resistant Staphylococcus aureus |
MRSE | Methicillin-resistant Staphylococcus epidermidis |
MRGN | Multi-resistant Gram-negative pathogens |
PD | Peritoneal dialysis |
spp. | Species |
VRE | Vancomycin-resistant enterococci |
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Total PD patients during timeframe, N | 129 |
Most recent PD modality (APD:CAPD:IPD) | 79:39:11 |
Sex (Male; Female) | 82; 47 |
Age at PD initiation, Median (25–75 CI), years | 69 (55–78) |
Age at first peritonitis episode, Median (25–75 CI), years | 73 (62–79) |
Time from PD initiation to first peritonitis episode, Median (25–75 CI), months | 13 (4–24) |
Relapsing peritonits, N (%) | 3 (3.75) |
Recurrent peritonitis, N (%) | 3 (3.75) |
Repeat peritonits, N (%) | 8 (10.0) |
Tunnel affection, N (%) | 6 (7.5) |
Peritonitis associated modality switch, N (%) * | 14 (17.5) |
Died in hospital related to peritonitis, N (%) | 2 (2.5) |
Microorganism | N (%) | Family | Potential Origin |
---|---|---|---|
Gram-Positives | 56 (56.57) | ||
Staphylococcus aureus | 14 (14.14) | Staphylococcaceae | upper respiratory tract and skin microbiota |
Staphylococcus epidermidis | 7 (7.07) | Staphylococcaceae | typically skin microbiota, less commonly the mucosal microbiota |
Staphylococcus haemolyticus | 6 (6.06) | Staphylococcaceae | skin microbiota |
Enterococcus faecialis | 4 (4.04) | Enterococcaceae | physiologic gastrointestinal tracts microbiota |
Streptococcus mitis | 4 (4.04) | Streptococcaceae | human mouth, throat, and upper respiratory tract microbiota |
Coagulase negative Staphylococci | 2 (2.02) | Staphylococcaceae | physiologic skin flora |
Staphylococcus capitis | 2 (2.02) | Staphylococcaceae | skin and nasal microbiota |
Streptococcus agalacitae | 2 (2.02) | Streptococcaceae | gastrointestinal and genitourinary tract microbiota |
Streptococcus dysgalactiae ssp. equisimilis | 2 (2.02) | Streptococcaceae | gastroinetstinal and genital tract, less commonly the skin flora. |
Streptococcus salivarius | 2 (2.02) | Streptococcaceae | the oral cavity and upper respiratory tract |
Actinomyces neuii | 1 (1.01) | Actinomycetaceae | vaginal microbiota |
Bacillus cereus | 1 (1.01) | Bacillaceae | found in earth and soil |
Brevibacterium casei | 1 (1.01) | Brevibacteriaceae | raw milk and cheese manufacturing |
Coyrnebacterium spp. | 1 (1.01) | Corynebacteriaceae | upper respiratory tract and skin microbiota |
Enterococcus spp. | 1 (1.01) | Enterococcaceae | gastrointestinal and genitourinary tract microbiota |
Listeria monozytogenes | 1 (1.01) | Listeriaceae | gastrointestinal, contaminated drinking water or food |
Micrococcus luteus | 1 (1.01) | Micrococcaceae | found in soil, dust, water and air, and as part of the microbiota of the mammalian skin |
Norcadia | 1 (1.01) | Nocardiaceae | oral microflora |
Staphylococcus hominis | 1 (1.01) | Staphylococcaceae | human and animal skin |
Streptococcus pneumoniae | 1 (1.01) | Streptococcaceae | respiratory tract, sinuses, and nasal cavity |
Streptococcus pyogenes | 1 (1.01) | Streptococcaceae | skin microbiota |
Gram-negatives | 31 (31.31) | ||
Escherichia coli | 9 (9.09) | Enterobacteriaceae | gastrointestinal and genitourinary tract |
Enterobacter cloacae | 5 (5.05) | Enterobacteriaceae | gastrointestinal microbiota |
Klebsiella oxytoca | 4 (4.04) | Enterobacteriaceae | opportunistic and gastrointestinal origin |
Serratia marcescens | 3 (3.03) | Yersiniaceae | ubiquitous in soil, water, animals and plants |
Acinetobacter baumanii | 2 (2.02) | Moraxellaceae | hospital environments; environmental soil and water samples |
Klebsiella pneumoniae | 3 (3.03) | Enterobacteriaceae | mouth, skin, and intestinal microbiota |
Acinetobacter pittii | 1 (1.01) | Moraxellaceae | skin and upper respiratory tract |
Bacteroides uniforms | 1 (1.01) | Bacteroidaceae | lower intestinal tract microbiota |
Pantonea agglomerans | 1 (1.01) | Enterobacteriaceae | commonly present on plant surfaces and animal or human feces |
Pasteurella multocida | 1 (1.01) | Pasteurellaceae | domestic cats and dogs normal respiratory microbiota |
Raoultella (Klebsiella) planticola | 1 (1.01) | Enterobacteriaceae | ubiquitous, may colonize plants, water, animals and humans |
Fungi | 3 (3.03) | ||
Candida parapsilosis | 2 (2.02) | Saccharomycetacea | hospital environments; catheter surfaces |
Candida spp. | 1 (1.01) | Saccharomycetaceae | hospital environments; catheter surfaces |
Other | 9 (9.09) | ||
culture-negative | 8 (8.08) | – | – |
no data record | 1 (1.01) | – | – |
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Albert, A.; Richter, S.; Costello-Boerrigter, L.C.; Stieger, P.; Woitas, R.P.; Braun-Dullaeus, R.C.; Albert, C. Microbiological Surveillance and Antimicrobial Susceptibility Observations on Peritoneal Dialysis-Associated Peritonitis in an Outpatient German Reference Center. Infect. Dis. Rep. 2025, 17, 49. https://doi.org/10.3390/idr17030049
Albert A, Richter S, Costello-Boerrigter LC, Stieger P, Woitas RP, Braun-Dullaeus RC, Albert C. Microbiological Surveillance and Antimicrobial Susceptibility Observations on Peritoneal Dialysis-Associated Peritonitis in an Outpatient German Reference Center. Infectious Disease Reports. 2025; 17(3):49. https://doi.org/10.3390/idr17030049
Chicago/Turabian StyleAlbert, Annemarie, Stefan Richter, Lisa C. Costello-Boerrigter, Philipp Stieger, Rainer Peter Woitas, Rüdiger C. Braun-Dullaeus, and Christian Albert. 2025. "Microbiological Surveillance and Antimicrobial Susceptibility Observations on Peritoneal Dialysis-Associated Peritonitis in an Outpatient German Reference Center" Infectious Disease Reports 17, no. 3: 49. https://doi.org/10.3390/idr17030049
APA StyleAlbert, A., Richter, S., Costello-Boerrigter, L. C., Stieger, P., Woitas, R. P., Braun-Dullaeus, R. C., & Albert, C. (2025). Microbiological Surveillance and Antimicrobial Susceptibility Observations on Peritoneal Dialysis-Associated Peritonitis in an Outpatient German Reference Center. Infectious Disease Reports, 17(3), 49. https://doi.org/10.3390/idr17030049