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Article: Epidemiology and Clinical Characteristics of Acinetobacter Peritoneal Dialysis-Related Peritonitis in Hong Kong—With a Perspective on Multi-Drug and Carbapenem Resistance

TitleEpidemiology and Clinical Characteristics of Acinetobacter Peritoneal Dialysis-Related Peritonitis in Hong Kong—With a Perspective on Multi-Drug and Carbapenem Resistance
Authors
KeywordsAcinetobacter
Peritoneal dialysis
Peritonitis
Multidrug resistance
Carbapenem resistance
Hong Kong
Issue Date2017
PublisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.com
Citation
Peritoneal Dialysis International, 2017, v. 37 n. 2, p. 177-182 How to Cite?
AbstractBackground: Acinetobacter spp. is an important cause of peritoneal dialysis (PD)-related peritonitis, but studies on Acinetobacter peritonitis have been scarce. In view of the rising concern of carbapenem-resistant Acinetobacter (CRA) and multidrug-resistant Acinetobacter (MDRA) infections, we conducted this study on the incidence of Acinetobacter peritonitis and the impact of CRA and MDRA on its outcome. Methods: We retrospectively evaluated the clinical characteristics, prevalence, antibiotic sensitivity patterns, outcomes, and factors associated with treatment failure over the past 16 years in our patients with Acinetobacter PD-related peritonitis. Results: Out of 2,389 episodes of peritonitis, there were 66 episodes (3%) of Acinetobacter peritonitis occurring in 59 patients. Twelve episodes were caused by MDRA (18%), of which 5 were CRA (8%). There was a progressive increase in the incidence of MDRA and CRA infections over the study period. Most isolates were sensitive to sulbactam combinations (ampicillin-sulbactam [95.4%] and cefoperazone-sulbactam [93.9%]), aminoglycosides (amikacin [92.4%], tobramycin [90.9%], and gentamicin [89.4%]), and carbapenems (imipenem [92.2%]). There was 1 case of relapse. Fifteen episodes resulted in catheter removal (23%), and 7 patients died (11%). Hypoalbuminemia (odds ratio [OR] = 0.85, p = 0.006) and carbapenem resistance (OR = 18.2, p = 0.049) were significantly associated with higher rates of treatment failure. Conclusion: Both carbapenem resistance and hypoalbuminemia were significantly associated with treatment failure. Up to 80% of peritonitis episodes by CRA resulted in catheter loss or mortality. Sulbactam combinations and/or aminoglycosides remained effective for the majority of Acinetobacter isolates. There seemed to be an increasing relative incidence of MDRA and CRA infections over the past 16 years.
Persistent Identifierhttp://hdl.handle.net/10722/241798
ISSN
2023 Impact Factor: 2.7
2023 SCImago Journal Rankings: 0.933
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLi, PH-
dc.contributor.authorCheng, VCC-
dc.contributor.authorYip, T-
dc.contributor.authorYap, DYH-
dc.contributor.authorLui, SL-
dc.contributor.authorLo, WK-
dc.date.accessioned2017-06-20T01:48:43Z-
dc.date.available2017-06-20T01:48:43Z-
dc.date.issued2017-
dc.identifier.citationPeritoneal Dialysis International, 2017, v. 37 n. 2, p. 177-182-
dc.identifier.issn0896-8608-
dc.identifier.urihttp://hdl.handle.net/10722/241798-
dc.description.abstractBackground: Acinetobacter spp. is an important cause of peritoneal dialysis (PD)-related peritonitis, but studies on Acinetobacter peritonitis have been scarce. In view of the rising concern of carbapenem-resistant Acinetobacter (CRA) and multidrug-resistant Acinetobacter (MDRA) infections, we conducted this study on the incidence of Acinetobacter peritonitis and the impact of CRA and MDRA on its outcome. Methods: We retrospectively evaluated the clinical characteristics, prevalence, antibiotic sensitivity patterns, outcomes, and factors associated with treatment failure over the past 16 years in our patients with Acinetobacter PD-related peritonitis. Results: Out of 2,389 episodes of peritonitis, there were 66 episodes (3%) of Acinetobacter peritonitis occurring in 59 patients. Twelve episodes were caused by MDRA (18%), of which 5 were CRA (8%). There was a progressive increase in the incidence of MDRA and CRA infections over the study period. Most isolates were sensitive to sulbactam combinations (ampicillin-sulbactam [95.4%] and cefoperazone-sulbactam [93.9%]), aminoglycosides (amikacin [92.4%], tobramycin [90.9%], and gentamicin [89.4%]), and carbapenems (imipenem [92.2%]). There was 1 case of relapse. Fifteen episodes resulted in catheter removal (23%), and 7 patients died (11%). Hypoalbuminemia (odds ratio [OR] = 0.85, p = 0.006) and carbapenem resistance (OR = 18.2, p = 0.049) were significantly associated with higher rates of treatment failure. Conclusion: Both carbapenem resistance and hypoalbuminemia were significantly associated with treatment failure. Up to 80% of peritonitis episodes by CRA resulted in catheter loss or mortality. Sulbactam combinations and/or aminoglycosides remained effective for the majority of Acinetobacter isolates. There seemed to be an increasing relative incidence of MDRA and CRA infections over the past 16 years.-
dc.languageeng-
dc.publisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.com-
dc.relation.ispartofPeritoneal Dialysis International-
dc.subjectAcinetobacter-
dc.subjectPeritoneal dialysis-
dc.subjectPeritonitis-
dc.subjectMultidrug resistance-
dc.subjectCarbapenem resistance-
dc.subjectHong Kong-
dc.titleEpidemiology and Clinical Characteristics of Acinetobacter Peritoneal Dialysis-Related Peritonitis in Hong Kong—With a Perspective on Multi-Drug and Carbapenem Resistance-
dc.typeArticle-
dc.identifier.emailLi, PH: liphilip@hku.hk-
dc.identifier.emailYap, DYH: desmondy@hku.hk-
dc.identifier.authorityLi, PH=rp02669-
dc.identifier.authorityYap, DYH=rp01607-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.3747/pdi.2016.00123-
dc.identifier.pmid27680764-
dc.identifier.scopuseid_2-s2.0-85029595297-
dc.identifier.hkuros272794-
dc.identifier.volume37-
dc.identifier.issue2-
dc.identifier.spage177-
dc.identifier.epage182-
dc.identifier.isiWOS:000397949800009-
dc.publisher.placeCanada-
dc.identifier.issnl0896-8608-

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