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Research Article
Yinghong Liu
Department of Nephrology, Second Xiangya Hospital, Central South University , Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, Hunan
Corresponding Author
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The microbiology and outcomes of peritoneal dialysis (PD) related peritonitis in elderly patients have not been thoroughly investigated. We aimed to investigate the microbiological distribution and clinical outcome in elderly patients with PD-associated peritonitis to guide clinical practice. We conducted a prospective, one center cohort study in Hunan province, China from September 1, 2014 to December 31, 2020. Among incident patients (n =279), basic clinical characteristics, pathogen distribution and prognosis of elderly PD patients (up to 65 years, n = 64) were compared with those of PD patients aged under 65 years (n = 215). The survival rate and technical survival rate were analyzed by Kaplan-Meier method. Among the 279 patients there were 394 peritonitis episodes, including 88 in elderly group, and 306 in younger groups. G+ bacteria were the main pathogenic bacteria in both groups (43.2% and 38.0%, respectively). Staphylococcus was the most common G+ bacteria. Peritonitis caused by fungal infection was significantly higher in elderly patients (P = 0.01), however, there is no significant difference in the proportions of G + bacteria and G- bacteria between the two groups. The most common G- bacteria was Escherichia coli. Interestingly, we found that Acinetobacter baumannii, polymicrobial infection and culture negative peritonitis in the elderly patients was significantly higher than that in other patients. Additionally, elderly PD patients had higher peritonitis-related mortality (HR=7.27, P = 0.01). However, the technical survival rate was similar (P = 0.67) in both elderly and other patients. Taken together, this retrospective cohort study found that elderly patients had a higher probability of peritonitis caused by of Acinetobacter baumannii, fungi and polymicrobial infections. In addition, the elderly peritonitis patients had a higher risk of mortality. Understanding the characteristics of microbiology and clinical outcome in elderly patients will help us to take effective measures to reduce the incidence of elderly PD-associated peritonitis.
Keywords
Elderly patient, peritoneal dialysis, peritonitis, microbiology, outcome
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Yinghong Liu
Department of Nephrology, Second Xiangya Hospital, Central South University , Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, Hunan
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 08 Apr, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Urology & Nephrology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The microbiology and outcomes of peritoneal dialysis (PD) related peritonitis in elderly patients have not been thoroughly investigated. We aimed to investigate the microbiological distribution and clinical outcome in elderly patients with PD-associated peritonitis to guide clinical practice. We conducted a prospective, one center cohort study in Hunan province, China from September 1, 2014 to December 31, 2020. Among incident patients (n =279), basic clinical characteristics, pathogen distribution and prognosis of elderly PD patients (up to 65 years, n = 64) were compared with those of PD patients aged under 65 years (n = 215). The survival rate and technical survival rate were analyzed by Kaplan-Meier method. Among the 279 patients there were 394 peritonitis episodes, including 88 in elderly group, and 306 in younger groups. G+ bacteria were the main pathogenic bacteria in both groups (43.2% and 38.0%, respectively). Staphylococcus was the most common G+ bacteria. Peritonitis caused by fungal infection was significantly higher in elderly patients (P = 0.01), however, there is no significant difference in the proportions of G + bacteria and G- bacteria between the two groups. The most common G- bacteria was Escherichia coli. Interestingly, we found that Acinetobacter baumannii, polymicrobial infection and culture negative peritonitis in the elderly patients was significantly higher than that in other patients. Additionally, elderly PD patients had higher peritonitis-related mortality (HR=7.27, P = 0.01). However, the technical survival rate was similar (P = 0.67) in both elderly and other patients. Taken together, this retrospective cohort study found that elderly patients had a higher probability of peritonitis caused by of Acinetobacter baumannii, fungi and polymicrobial infections. In addition, the elderly peritonitis patients had a higher risk of mortality. Understanding the characteristics of microbiology and clinical outcome in elderly patients will help us to take effective measures to reduce the incidence of elderly PD-associated peritonitis.
Figure 1
Figure 2
No competing interests reported.
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