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Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: The aim of this study was to clarify the etiology, clinical presentation, treatment of peritonitis, peritonitis rate, and to analyze the microbiologic profile of peritonitis in our pediatric dialysis unit. METHODS: This study was performed with children treated with chronic peritoneal dialysis and diagnosed for peritonitis during the period from January 2004 to December 2011 at the Peritoneal Dialysis Unit of our Pediatric Nephrology Department. RESULTS: The patient cohort comprised 55 patients (30 males, 25 females) who were treated for peritoneal dialysis related peritonitis. The total number of peritonitis episodes was 157. The mean peritonitis rate was one episode per 23.9 patient-months; one episode per 26.8 patient-months for continuous ambulatory peritoneal dialysis and one episode per 20.1 patient-months for automated peritoneal dialysis. The yield of culture positivity was 69.5% with %42.6 gram-positive, 19.7% gramnegative, 3.8% polymicrobial gram-positive, 0.6% polymicrobial gram-negative, 0.6% polymicrobial mixed, 1.3% fungal and 0.6% anaerobic organisms. Coagulase-negative staphylococcus was the most common cause, accounting for 17.1% of all episodes. The mean number of peritonitis episodes was 3±2.3 in 42 patients with double-cuffed swan neck catheter whereas the number of peritonitis episodes was 2.3±1.6 in 13 patients with double-cuffed tenckhoff catheter. There was no relation between catheter type and the number of peritonitis episodes (p>0.05). DISCUSSION and CONCLUSION: In conclusion, neither the dialysis modality, catheter type, nor the catheter insertion techniques have a definite effect on the development of a perionitis episode. This directs us to consider the importantance of the training program given to the caregivers. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Peritonitis is the most important complication of Continuous Ambulatory Peritoneal Dialysis (CAPD) treatment. The most powerful defending elements of peritoneal fluid are IgG and the IgG subclasses. Low levels of IgG subclasses result in recurrent infections. We therefore aimed to investigate the peritonitis frequency and serum-dialysate IgG subclass level relationship. MATERIAL and METHODS: A total of 30 CAPD patients were included in this study. The patients were divided into two groups according to their peritonitis frequency. Patients with two or more peritonitis attack were grouped as High Peritonitis Index (HPI) and those with one or less peritonitis attack as Low Peritonitis Index (LPI). 17 (56.67%) patients were in the LPI and 13 (43.33%) patients in the HPI group. These two groups were compared for their IgG subclass levels. RESULTS: There was no significant difference for serum IgG and subclass levels (p IgG1:0.86, IgG2:0.93, IgG3:0.4, IgG4:0.67, total IgG:0.80 mg/ml). Dialysate IgG and subclass levels were significantly higher in the HPI group (p IgG1:0.006, IgG2:0.01, IgG3:0.007, IgG4:0.01, total IgG:0.003 mg/ml). The loss of total protein, albumin and globulin in the dialysate was significantly higher in the HPI group (respectively p=0.39, 0.26, 0.01). CONCLUSION: Structural changes in the peritoneal membrane and a recurrent inflamatory response may result in high IgG and subclass level for the HPI group. Our results show that low levels of IgG subclasses may not play an important role in the development of peritonitis. [ABSTRACT FROM AUTHOR]

Peritonitis is one of the most common and important complications in patients on continuous ambulatory peritoneal dialysis (CAPD), that is associated with significant morbidity and mortality. Gram negative bacteria are the causative agents in % 20-30 of peritoneal dialysis related peritonitis case. Moellerella winconsensis is a recently-identified member of the Enterobacteriaceae family. Although pathogenicity of M.wisconsensis remains unclear in humans, it is found associated with diarrhea and acute cholecystitis with or without secondary bacteremia only in a few cases. In this report, a case of peritoneal dialysis-related peritonitis caused by M. wisconsensis is presented. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine clinical characteristics, etiological agents, and their antibiotic susceptibilities in continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis encountered in our hospital. Methods: Thirty patients with peritonitis attack among 55 adult patients aged ≥18 years, who applied to Nephrology Clinic of Fırat University Hospital between January 2012 and February 2013 and who were monitored in the CAPD unit were included in this prospective study. Cultures were performed on both solid media and blood culture bottles according to the recommendations of International Society for Peritoneal Dialysis. Antibiotic susceptibilities were investigated by disk diffusion method. Results: During clinical evaluation, abdominal guarding (n=28, 93.3%), rebound tenderness (n=4, 13.3%), fever (n=9, 30%), nausea and vomiting (n=13, 43.3%), and diarrhea (n=5, 16.7%) were detected. Turbid dialysis fluid and abdominal pain were noted in all patients. Direct Gram staining yielded positive result in 1 (3.3%) patient. In 28 (93.3%) patients bacterial growth was detected in the cultures. Bacterial growth was detected on solid culture media in 14 (46.7%), and blood culture bottles in 28 (93.3%) patients. In 2 (6.7%) patients, bacterial growth was not detected in both media. The same microorganisms were identified in both methods, and their antibiograms yielded similar results. Gram-positives included coagulase-negative staphylococci (n=16, 57.1%), Staphylococcus aureus (n=4, 14.3%), streptococci (n=4, 14.3%), and enterococci (n=1, 3.6%). Gram-negatives consisted of Escherichia coli (n=2), and Yersinia enterocolitica (n=1). In 46.2% of Gram-positive microorganisms penicillin resistance was detected, while 9.5% of staphylococci were methicillin-resistant. Conclusions: Each health center should have knowledge of its prevalent microbial agents, and their susceptibility profile, which is essential for the determination of suitable alternative empirical treatment. This strategy will obviate unnecessary use of antibiotics, and contribute to the decrease in the potential development of antibiotic resistance. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to determine the incidence of peritonitis in patients with continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis, microorganisms causing peritonitis and the clinical course of patients during the 15-year study period. MATERIAL and METHODS: A total of 61 patients (26 male, 35 female) with CAPD-related peritonitis treated in our hospital between 2000-2014 were enrolled into this study. RESULTS: During the study period, 103 episodes of peritonitis were observed, with a mean incidence of 0.29 episodes per patient year. Overall, 58.3% of the episodes were due to gram-positive organisms, 7.8% due to gram-negative organisms and 30.1% were culture negative. The treatment was successful in 96.1% of the episodes, and removal of the Tenckhoff catheter was required in 4 patients. It was observed when the distribution of the causative organisms over the years were examined that the number of CAPD peritonitis and the rate of culture-negative episodes decreased after the year 2008. CONCLUSION: In our center, the main causes of peritonitis were gram-positive microorganisms. During follow-up, the incidence of peritonitis and the rate of culture-negative episodes decreased but there was no change in the gram stain characteristics of organisms. Reducing the incidence of CAPDrelated peritonitis could be possible by providing intensive training to patients and strict monitoring. [ABSTRACT FROM AUTHOR]

Objective: This study is aimed to evaluate depression and anxiety levels and coping strategies with stress in continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) patients. Method: Study which was planned as a descriptive cross-sectional research has been made among patients who were under treatment with CAPD or HD for chronic renal failure in Cumhuriyet University Hospital in 01-31 August 2007. Questions were asked to determine the demographic profile, tobacco and alcohol use patterns and psychological status of the patients. Beck Depression Inventory and State-Trait Anxiety Inventory I-II (STAI-I, STAI-II) and Coping Strategies With Stress Inventory (COPE) were used for psychological evaluation. Results: Depression rate was 33.3% in CAPD patients and 61.3% in HD patients. Beck Depression Inventory and State-Trait Anxiety Inventory I-II (STAI-I, STAI-II) scores were 14.1±8.4, 39.3±4.7, 47.6±5.1 and 19.9±9.9, 41.0±3.7, 49.5±6.2 in CAPD and HD patients respectively. CAPD patients' depression scores were significantly lower than HD patients' (p<0.05) whereas there was no significant difference between Beck Depression Inventory and State-Trait Anxiety Inventory scores (p>0.05). In both groups the most frequently used coping strategy was religious coping followed by positive re-interpretation and development methods. The only significant difference between groups were in "to laugh it off" and "not to worry about it" strategies. Conclusion: Depression and anxiety appeared frequently in all dialysis patients, but depression was more frequent in HD patients. Therefore it is considered necessary for dialysis patients (CAPD and HD) to be under regular psychiatric evaluation. [ABSTRACT FROM AUTHOR]

Stenotrophomonas maltophilia is an important nosocomial pathogen, particularly in immunosuppressed patients and is resistant to multiple antibiotics. S. maltophilia peritonitis in continuous ambulatory peritoneal dialysis patients is rarely observed. It usually has poor prognosis and sometimes can result in loss of continuous ambulatory peritoneal dialaysis (CAPD) catheter. In this manuscript, peritonitis due to S. maltophilia in a 41-year-old female undergoing CAPD due to chronic renal failure is presented. [ABSTRACT FROM AUTHOR]