Rates and Causes of Peritonitis in a National Multicenter Continuous Ambulatory Peritoneal Dialysis Program in Sudan: First-year Experience
Rates and Causes of Peritonitis in a National Multicenter Continuous Ambulatory Peritoneal Dialysis Program in Sudan: First-year Experience
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Date
2007-11
Authors
Hasan Abu-Aisha
Elwaleed A. Elhassan
Ammar H. Khamis
Haleema Fedail
Babikir Kaballo
M. Babbikir Abdelraheem
Tigani Ali
Safaa Medani
Layla Tammam
Ihsan Basheir2
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Publisher
Saudi Center for Organ Transplantation
Abstract
This is a cumulative report of all patients in six centers in Greater Khartoum, all three cities
that comprise the capital of Sudan, covering the first year of operation of the National Program. This study
evaluates the rates, mechanisms, causative agents and clinical outcomes of peritonitis. We included the data
of all 60 patients who underwent CAPD from June 2005 to June 2006. There were 15 episodes of peritonitis
in 323 patient-months, which equates to an overall peritonitis rate of one episode every 21.5 months (0.55
episodes per year at risk). The individual center rates varied. There was a statistically significant age
difference, with peritonitis being more common in the youngsters. All patients presented with abdominal
pain and had cloudy effluents but none had a significant exit site or tunnel infection. Fluid cultures were
available in 11 out of the 15 episodes of peritonitis. The cultures were positive for organisms in only 3 out
of 11 (27%) cases. Two patients were infected by Pseudomonas aerogenosa and one patient by
Staphylococcus aureus. Thus, the culture-negative peritonitis rate was 8/11 (73%). Touch contamination
was the likely mechanism in 7/15 (46.7%) of the episodes. There were three cases of refractory peritonitis
and only one case of relapsing peritonitis. None of the patients had a catheter removed because of
peritonitis. We conclude that the first year of operation of the Sudan National Multi-centered PD program
has proven that it is a promising project with multifaceted success. The cumulative peritonitis incidence is
acceptable although there are several areas for improvement. Standardized laboratory techniques need to be
implemented and pursued, particularly in the microbiology area.
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Citation
Abu-Aisha, H., Elhassan, E.A., Khamis, A.H., Fedail, H., Kaballo, B., Abdelraheem, M.B., Ali, T., Medani, S., Tammam, L. and Basheir, I., 2007. Rates and causes of peritonitis in a National Multicenter Continuous Ambulatory Peritoneal Dialysis program in Sudan: first-year experience. Saudi Journal of Kidney Diseases and Transplantation, 18(4), p.565.