TY - JOUR
T1 - Outcomes of corynebacterium peritonitis
T2 - A multicenter registry analysis
AU - Htay, Htay
AU - Cho, Yeoungjee
AU - Pascoe, Elaine M.
AU - Darssan, Darsy
AU - Hawley, Carmel
AU - Clayton, Philip A.
AU - Borlace, Monique
AU - Badve, Sunil V.
AU - Sud, Kamal
AU - Boudville, Neil
AU - McDonald, Stephen P.
AU - Johnson, David W.
N1 - Funding Information:
DWJ has received consultancy fees, research grants, speaker’s honoraria and travel sponsorships from Baxter Healthcare and Fresenius Medical Care. He is supported by a National Health and Medical Research Council Practitioner Fellowship. YC has received research grants from Fresenius Medical Care. She is supported by a National Health and Medical Research Council Early Career Fellowship. CH has previously received research grants and travel sponsorships from Baxter Healthcare and Fresenius Medical Care. KS has received speaker’s honoraria from Baxter Healthcare, Roche, Amgen, and Boehringer Ingelheim and conference or meeting sponsorships from Shire, Roche, Boehringer Ingelheim, Amgen, Sanofi, and Novartis. All other authors have no conflicts of interest to declare.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - ♦ Background: Corynebacterium is a rare cause of peritonitis that is increasingly being recognized in peritoneal dialysis (PD) patients. The aims of this study were to compare Corynebacterium peritonitis outcomes with those of peritonitis caused by other organisms and to examine the effects of type and duration of antibiotic therapy on outcomes of Corynebacterium peritonitis. ♦ Methods: Using Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data, we included all PD patients who developed peritonitis in Australia between 2004 and 2014. The primary outcome was peritonitis cure by antibiotic therapy, defined as resolution of a peritonitis episode with antibiotics alone and without being complicated by recurrence, relapse, catheter removal, hemodialysis transfer, or death. Peritonitis outcomes were analyzed using multivariable logistic regression. ♦ Results: A total of 11,122 episodes of peritonitis in 5,367 patients were included. Of these, 162 episodes (1.5%) were due to Corynebacterium. Compared with Corynebacterium peritonitis, the odds of cure were lower in peritonitis due to Staphylococcus aureus (odds ratio [OR] 0.66, 95% confidence interval [CI] 0.45 – 0.97), Pseudomonas (OR 0.22, 95% CI 0.14 – 0.33), other gram-negative organisms (OR 0.52, 95% CI 0.35 – 0.75), fungi (OR 0.02, 95% CI 0.01 – 0.03), polymicrobial organisms (OR 0.32, 95% CI 0.22 – 0.47), and other organisms (OR 0.66, 95% CI 0.44 – 0.99) but similar for culture-negative and other gram-positive peritonitis. Similar results were observed for hemodialysis transfer and death. The outcomes of Corynebacterium peritonitis were not associated with the type of initial antibiotic selected (vancomycin vs cefazolin) or the duration of antibiotic therapy (≤ 14 days vs > 14 days). ♦ Conclusions: Outcomes for Corynebacterium peritonitis are generally favorable compared with other forms of peritonitis. Cure rates did not appear to differ if peritonitis was treated initially with vancomycin or cefazolin or if treatment duration was prolonged beyond 14 days.
AB - ♦ Background: Corynebacterium is a rare cause of peritonitis that is increasingly being recognized in peritoneal dialysis (PD) patients. The aims of this study were to compare Corynebacterium peritonitis outcomes with those of peritonitis caused by other organisms and to examine the effects of type and duration of antibiotic therapy on outcomes of Corynebacterium peritonitis. ♦ Methods: Using Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data, we included all PD patients who developed peritonitis in Australia between 2004 and 2014. The primary outcome was peritonitis cure by antibiotic therapy, defined as resolution of a peritonitis episode with antibiotics alone and without being complicated by recurrence, relapse, catheter removal, hemodialysis transfer, or death. Peritonitis outcomes were analyzed using multivariable logistic regression. ♦ Results: A total of 11,122 episodes of peritonitis in 5,367 patients were included. Of these, 162 episodes (1.5%) were due to Corynebacterium. Compared with Corynebacterium peritonitis, the odds of cure were lower in peritonitis due to Staphylococcus aureus (odds ratio [OR] 0.66, 95% confidence interval [CI] 0.45 – 0.97), Pseudomonas (OR 0.22, 95% CI 0.14 – 0.33), other gram-negative organisms (OR 0.52, 95% CI 0.35 – 0.75), fungi (OR 0.02, 95% CI 0.01 – 0.03), polymicrobial organisms (OR 0.32, 95% CI 0.22 – 0.47), and other organisms (OR 0.66, 95% CI 0.44 – 0.99) but similar for culture-negative and other gram-positive peritonitis. Similar results were observed for hemodialysis transfer and death. The outcomes of Corynebacterium peritonitis were not associated with the type of initial antibiotic selected (vancomycin vs cefazolin) or the duration of antibiotic therapy (≤ 14 days vs > 14 days). ♦ Conclusions: Outcomes for Corynebacterium peritonitis are generally favorable compared with other forms of peritonitis. Cure rates did not appear to differ if peritonitis was treated initially with vancomycin or cefazolin or if treatment duration was prolonged beyond 14 days.
KW - Antibiotic
KW - Corynebacterium infections
KW - End-stage kidney disease
KW - Outcomes
KW - Peritoneal dialysis
KW - Peritonitis
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85033587639&partnerID=8YFLogxK
U2 - 10.3747/pdi.2017.00028
DO - 10.3747/pdi.2017.00028
M3 - Article
C2 - 28698253
AN - SCOPUS:85033587639
SN - 0896-8608
VL - 37
SP - 619
EP - 626
JO - Peritoneal Dialysis International
JF - Peritoneal Dialysis International
IS - 6
ER -