2015, Number 3
<< Back Next >>
Rev Invest Clin 2015; 67 (3)
Risk Factors Associated with Nosocomial Peritonitis in Children on Peritoneal Dialysis
López-González D, Garduño J, Reyes-López A, Partida-Gaytán A, Medeiros M
Language: English
References: 31
Page: 170-176
PDF size: 207.75 Kb.
ABSTRACT
Background: Peritoneal dialysis is the most frequent dialysis method in children, and peritonitis is a frequent complication. The
responsible organisms differ between nosocomial and community acquired peritonitis, they cause longer hospitalization time,
and can lead to dialysis failure.
Objective: The aim of the study was to describe the risk factors associated with nosocomial
peritonitis in children with end-stage renal disease undergoing dialysis treatment.
Methods: A nested case-control study was
conducted in an academic medical center.
Subjects: The basic cohort included all pediatric patients with end-stage renal disease
undergoing continuous ambulatory peritoneal dialysis therapy and who were hospitalized for non-infectious causes during the
study period, January 2008 to December 2009. Cases were subjects who developed nosocomial peritonitis during hospitalization,
and controls were children free of nosocomial peritonitis. The final groups consisted of 10 cases and 35 controls.
Results: There
were 11 episodes of nosocomial peritonitis in 10 subjects (incidence rate, 6.6 cases per year of hospitalization). By multiple
logistic regression analysis, the presence of congenital abnormalities of the kidney and urinary tract was the only risk factor
significantly associated with nosocomial peritonitis (OR: 11.54; 95% CI: 1.86-71.59).
Conclusion: Congenital abnormality of
the kidney and urinary tract was a significant risk factor for nosocomial peritonitis in pediatric patients with end-stage renal
disease undergoing peritoneal dialysis.
REFERENCES
Chadha V, Schaefer FS, Warady BA. Dialysis-associated peritonitis in children. Pediatr Nephrol. 2009;25:425-40.
North American Pediatric Renal Trials and Collaborative Studies. NAPRTCS 2011 Annual Dialysis Report. Available at: https:// web.emmes.com/study/ped/annlrept/annualrept2011.pdf
Schaefer F, Feneberg R, Aksu N, et al. Worldwide variation of dialysis-associated peritonitis in children. Kidney Int. 2007; 72:1374-9.
Warady BA. Peritoneal dialysis and the pediatric patient. Perit Dial Int. 2012;32:393-4.
Warady BA, Bakkaloglu S, Newland J, et al. Consensus guidelines for the prevention and treatment of catheter-related infections and peritonitis in pediatric patients receiving peritoneal dialysis: 2012 update. Perit Dial Int. 2012;32(Suppl 2):S32-86.
Warady BA, Feneberg R, Verrina E, et al. Peritonitis in children who receive long-term peritoneal dialysis: A prospective evaluation of therapeutic guidelines. J Am Soc Nephrol. 2007;18:2172-9.
Mayon-White RT, Ducel G, Kereselidze T, Tikomirov E. An international survey of the prevalence of hospital-acquired infection. J Hosp Infect. 1988;11(Suppl A):43-8.
Monteon F, Correa-Rotter R, Paniagua R, et al. Prevention of peritonitis with disconnect systems in CAPD: A randomized controlled trial. The Mexican Nephrology Collaborative Study Group. Kidney Int. 1998;54:2123-8.
Fabian Velasco R, Lagunas Munoz J, Sanchez Saavedra V, et al. Automated peritoneal dialysis as the modality of choice: A singlecenter, 3-year experience with 458 children in Mexico. Pediatr Nephrol. 2008;23:465-71.
Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988;16:128-40.
Larson E, Horan T, Cooper B, Kotilainen HR, Landry S, Terry B. Study of the definition of nosocomial infections (SDNI). Research Committee of the Association for Practitioners in Infection Control. Am J Infect Control. 1991;19:259-67.
Troidle L, Kliger AS, Goldie SJ, et al. Continuous peritoneal dialysis- associated peritonitis of nosocomial origin. Perit Dial Int. 1996;16:505-10.
García-García L, Jiménez-Corona ME, Ramírez-López LE, et al. Surveillance of nosocomial infections in a Mexican community hospital. How are we doing? Salud Pública Méx. 2010;52:511-6.
Norma Oficial Mexicana NOM-045-SSA2-2005, para la vigilancia epidemiológica, prevención y control de las infecciones nosocomiales. Available at: http://dof.gob.mx/nota_detalle. php?codigo=5120943&fecha=20/11/2009
Piraino B, Bailie GR, Bernardini J, et al. Peritoneal dialysis-related infections recommendations: 2005 update. Perit Dial Int. 2005;25:107-31.
Warady BA, Schaefer F, Holloway M, et al. Consensus guidelines for the treatment of peritonitis in pediatric patients receiving peritoneal dialysis. Perit Dial Int. 2000;20:610-24.
Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36:309-32.
Harambat J, van Stralen KJ, Kim JJ, Tizard EJ. Epidemiology of chronic kidney disease in children. Pediatr Nephrol. 2012;27:363-73.
Ardissino G, Dacco V, Testa S, et al. Epidemiology of chronic renal failure in children: Data from the Italkid project. Pediatrics. 2003;111:e382-7.
Klaus G. Prevention and treatment of peritoneal dialysis-associated peritonitis in pediatric patients. Perit Dial Int. 2005;25(Suppl 3):S117-9.
Schaefer F, Borzych-Duzalka D, Azocar M, et al. Impact of global economic disparities on practices and outcomes of chronic peritoneal dialysis in children: Insights from the international pediatric peritoneal dialysis network registry. Perit Dial Int. 2012;32:399-409.
Barretti P, Bastos KA, Dominguez J, Caramori JC. Peritonitis in Latin America. Perit Dial Int. 2007;27:332-9.
Akman S, Bakkaloglu SA, Ekim M, Sever L, Noyan A, Aksu N. Peritonitis rates and common microorganisms in continuous ambulatory peritoneal dialysis and automated peritoneal dialysis. Pediatr Int. 2009;51:246-9.
Medeiros-Domingo M, Velásquez-Jones L, Calvillo-Delgado O, et al. Complicaciones de la diálisis peritoneal continua ambulatoria en niños con insuficiencia renal crónica. Bol Med Hosp Infant Mex. 1997;54:182-8.
Pérez Fontan M, Rodríguez-Carmona A, García-Naveiro R, Rosales M, Villaverde P, Valdés F. Peritonitis-related mortality in patients undergoing chronic peritoneal dialysis. Perit Dial Int. 2005;25:274-84.
Wong SS, Ho PL, Yuen KY. Evolution of antibiotic resistance mechanisms and their relevance to dialysis-related infections. Perit Dial Int. 2007;27(Suppl 2):S272-80.
Bakkaloglu SA. Prevention of peritonitis in children: Emerging concepts. Perit Dial Int. 2009;29(Suppl 2):S186-9.
Firanek C, Guest S. Hand hygiene in peritoneal dialysis. Perit Dial Int. 2011;31:399-408.
Piraino B, Bernardini J, Brown E, et al. ISPD position statement on reducing the risks of peritoneal dialysis-related infections. Perit Dial Int. 2011;31:614-30.
Cheng VC, Tai JW, Chau PH, et al. Minimal intervention for controlling nosocomial transmission of methicillin-resistant Staphylococcus aureus in resource limited setting with high endemicity. PLoS One. 2014;9:e100493.
Cheng VC, Tai JW, Chen JH, So SY, Ng WC, Hung IF, et al. Proactive infection control measures to prevent nosocomial transmission of vancomycin-resistant enterococci in Hong Kong. J Formos Med Assoc. 2014;113:734-41.