Apart from Escherichia coli, the other most common organism implicated in acute suppurative bacterial peritonitis is-
• When bacteria contaminate the peritoneum as a result of spillage from an intra-abdominal viscus.
• Infection in secondary bacterial peritonitis is polymicrobial
• E. coli and Bacteroides are MC organisms.
• The species of organism isolated vary with the source of the initial process and the normal flora present at the site.
• Peritonitis is one of the MC complications of CAPDQ, occurring with an incidence of approximately one episode every 1 to 3 years.
• Refractory or recurrent peritonitis is MC cause of technical failure of CAPD.
• MC organism: Staphylococcus epidermidis (30–50%).
Clinical Features
• Patients present with abdominal pain, fever, and cloudy peritoneal dialysate containing >100 WBC/mm3, with >50% of the cells being neutrophils.
• Gram staining detects organisms only in 10–40% of cases.
Treatment
• CAPD associated peritonitis is treated by the intraperitoneal administration of antibiotics, usually a first-generation cephalosporin.
• Overall, 75% of infections are cured by culture-directed antibiotic therapy.
• Recurrent or persistent peritonitis requires removal of the dialysis catheter and resumption of hemodialysis.
Bacteroides
Klebsiella
Peptostreptococcus
Pseudomonas