Academic Journal
Variability in Culture-Negative Peritonitis Rates in Pediatric Peritoneal Dialysis Programs in the United States
| العنوان: | Variability in Culture-Negative Peritonitis Rates in Pediatric Peritoneal Dialysis Programs in the United States |
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| المؤلفون: | Davis, T. Keefe, Bryant, Kristina A., Rodean, Jonathan, Richardson, Troy, Selvarangan, Rangaraj, Qin, Xuan, Neu, Alicia, Warady, Bradley A. |
| المصدر: | Clinical Journal of the American Society of Nephrology ; volume 16, issue 2, page 233-240 ; ISSN 1555-9041 1555-905X |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: | 2021 |
| الوصف: | Background and objectives International guidelines suggest a target culture-negative peritonitis rate of <15% among patients receiving long-term peritoneal dialysis. Through a pediatric multicenter dialysis collaborative, we identified variable rates of culture-negative peritonitis among participating centers. We sought to evaluate whether specific practices are associated with the variability in culture-negative rates between low– and high–culture-negative rate centers. Design, setting, participants, & measurements Thirty-two pediatric dialysis centers within the Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) collaborative contributed prospective peritonitis data between October 1, 2011 and March 30, 2017. Clinical practice and patient characteristics were compared between centers with a ≤20% rate of culture-negative peritonitis (low-rate centers) and centers with a rate >20% (high-rate centers). In addition, centers completed a survey focused on center-specific peritoneal dialysis effluent culture techniques. Results During the 5.5 years of observation, 1113 patients had 1301 catheters placed, totaling 19,025 patient months. There were 620 episodes of peritonitis in 378 patients with 411 catheters; cultures were negative in 165 (27%) peritonitis episodes from 125 (33%) patients and 128 (31%) catheters. Low-rate centers more frequently placed catheters with a downward-facing exit site and two cuffs ( P <0.001), whereas high-rate centers had more patients perform dialysis themselves without the assistance of an adult care provider ( P <0.001). The survey demonstrated that peritoneal dialysis effluent culture techniques were highly variable across centers. No consistent practice or technique helped to differentiate low- and high-rate centers. Conclusions Culture-negative peritonitis is a frequent complication of maintenance peritoneal dialysis in children. Despite published recommendations for dialysis effluent collection and culture methods, great variability ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.2215/cjn.09190620 |
| DOI: | 10.2215/CJN.09190620 |
| الاتاحة: | http://dx.doi.org/10.2215/cjn.09190620 https://journals.lww.com/10.2215/CJN.09190620 |
| رقم الانضمام: | edsbas.14000593 |
| قاعدة البيانات: | BASE |
| DOI: | 10.2215/cjn.09190620 |
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