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First published on June 17, 2010
Peritoneal Dialysis International 2010, doi:10.3747/pdi.2009.00241
Perit Dial Int 0(2010): 200900241-
2010
© 2010 International Society for Peritoneal Dialysis
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Research

DISCORDANT PD CATHETER AND EFFLUENT CULTURE RESULTS. THE LIMITEDCLINICAL RELEVANCE OF CULTURING PD CATHETERS

Tom Cornelis1, Joanne M. Bargman2, Maggie Chu3, Antigone Oreopoulos4, Saimah Khan5 and Dimitrios G. Oreopoulos6

1Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
2Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
3Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
4School of Public Health, University of Alberta, Edmonton, Alberta, Canada
5Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
6Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada

T. Cornelis, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada. tomcor77{at}gmail.com

ABSTRACT

Objectives: To determine if discordance in culture results between the effluent and the tip of the peritoneal catheter had an effect on outcome in patients whose peritoneal dialysis (PD) catheter was removed mostly for nonresolving peritonitis. Reasons for and outcomes of PD catheter removal were also analyzed.

Methods: We retrospectively reviewed the charts of all PD patients with recent peritonitis for which the PD catheter was removed between 1 January 2003 and 30 April 2009. Data including basic demographics, the organism isolated from effluent and from the PD catheter, reason for catheter removal, duration of hospitalization, and development of intra-abdominal collection were extracted as well as mortality within 8 weeks post removal and return to PD after catheter removal.

Results: Fungal peritonitis was the most common reason for PD catheter removal. 20% of the patients developed an intra-abdominal collection. Mortality related to PD catheter removal was low (3/53; 5.6%). The patients (n =53) were divided into 3 groups: group 1 (n = 20) had the same culture result of effluent and catheter tip; group 2 (n = 19) had a negative culture of the catheter tip; and group 3 (n = 14) had different organism(s) growing from effluent and catheter tip. We found no remarkable differences in duration of PD, catheter age, peritonitis rate, or mortality. Patients in group 1 had significantly more fungal peritonitis than the other 2 groups. In only 4 of the 53 patients (7.5%), the anti-infectious management was changed according to the catheter culture result.

Conclusions: Discordant results between catheter tip culture and effluent culture did not have a significant impact on patient outcome. Sending PD catheters for culture has limited clinical importance.

KEY WORDS: Outcome; peritonitis; peritoneal catheter removal.

Received 28 November 2009; Revision received 1 March 2010. accepted 3 May 2010.






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