Fungal Peritonitis in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients DC06-DC09
Dr. Usha Kalawat,
Professor, Department of Microbiology, SVIMS, Tirupati-517507, Andhra Pradesh, India.
Introduction: Continuous Ambulatory Peritoneal Dialysis (CAPD) is a well established treatment modality for End Stage Renal Disease (ESRD) which has advantages in providing mobility and more independence to the patient but at the same time some complication are more commonly associated with it. Fungal Peritonitis (FP) is one of such complications which although rare, is a serious concern with failure of the technique and fatal outcome.
Aim: To analyse the incidence, associated risk factors and the outcome of FP in CAPD patients.
Materials and Methods: This was a ten year (2008-2017) retrospective study conducted on 180 ESRD patients who were on continuous ambulatory peritoneal dialysis. Case sheets were retrieved from medical record department section and data was analysed.
Results: The incidence of FP was 10%, with female’s preponderance (55.5%). The most common fungus isolated was Candida albicans in 61.1% patients (11), followed by Aspergillus niger 22.2% (4), Curvularia lunata 11.1% (2) and Fusarium spp in 5.5% (1) in descending order. On the diagnosis of FP, catheter was removed immediately and the patient was treated appropriately. Re-insertion was done in 22.2% of patients, whereas 33.3% patients were shifted to haemodialysis and 44.4% patients expired. Filamentous fungi were the cause for 75% of the mortality.
Conclusion: Candida spp remains the most common cause of FP but filamentous fungi are more commonly associated with fatal outcome.