S-Space College of Medicine/School of Medicine (의과대학/대학원) Pediatrics (소아과학전공) Journal Papers (저널논문_소아과학전공)
Worldwide variation of dialysis-associated peritonitis in children
- Issue Date
- Nature Publishing Group
- Kidney Int 2007; 72: 1374-1379
- Adolescent ; Anti-Bacterial Agents/*therapeutic use ; Argentina ; Asia ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Europe ; Gram-Negative Bacterial Infections/drug therapy/etiology ; Gram-Positive Bacterial Infections/drug therapy/etiology ; Humans ; Incidence ; Infant ; Infant, Newborn ; International Cooperation ; Mexico ; Peritoneal Dialysis/*adverse effects ; Peritonitis/*drug therapy/*etiology/microbiology ; Prospective Studies ; Registries/*statistics & numerical data ; Treatment Outcome ; Turkey ; United States ; Practice Guidelines as Topic
- Peritonitis is the most common cause of dialysis failure in children on chronic peritoneal dialysis. We performed a prospective study of 501 peritonitis episodes in 44 pediatric dialysis centers located in 14 countries that examined peritonitis etiology, efficiency of opinion-based management guidelines, and final outcomes. Culture-negative incidence varied significantly from 11% in North America to 67% in Mexico. Argentina and North America had the highest rate of Gram-negative episodes. Pseudomonas-based peritonitis was eightfold more common in the United States than in Europe, and correlated with the frequency of exit site cleansing and topical mupirocin administration. Significant regional variation in antibiotic susceptibility was noted for the first generation cephalosporins and aminoglycosides. Initial response rates to standardized empiric antibiotic treatment did not differ between regions; however, final outcomes were significantly less favorable in Eastern Europe. The wide regional variation in culture-negative peritonitis, and the distribution and antibiotic susceptibilities of causative bacteria needs to be taken into consideration when the guidelines for empiric therapy of pediatric dialysis-associated peritonitis are revised.
- 0085-2538 (Print)
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