Fungal peritonitis in patients undergoing continuous ambulatory peritoneal dialysis in Qatar

  • Fahmi Yousef Khan Hamad General Hospital, Doha, Qatar
  • Mohammed Elsayed Hamad General Hospital, Doha, Qatar
  • Deshmukh Anand Hamad General Hospital, Doha, Qatar
  • Mohammed Abu Khattab Hamad General Hospital, Doha, Qatar
  • Doiphode Sanjay Hamad General Hospital, Doha, Qatar
Keywords: amphotericin B, CAPD, Candida parapsilosis, fungal peritonitis, fluconazole

Abstract

Introduction: This study was conducted at Hamad General Hospital to determine the incidence of fungal peritonitis and to describe its clinical and microbiological findings in patients undergoing continuous ambulatory peritoneal dialysis in Qatar.

Methodology: The medical records of these patients between 1 January 2005 and 31 December 2008 were retrospectively reviewed and the collected data were analysed.

Results: During the study period, 141 episodes of peritonitis were observed among 294 patients. In 14 of these episodes (9.9%), fungal peritonitis was reported in 14 patients with a rate of 0.05 episodes per patient year, while the bacterial peritonitis rate was 0.63 per patient year. Thirteen (93%) patients had one or more previous episodes of bacterial peritonitis that was treated with multiple broad-spectrum antibiotics, 11 (85%) had received broad-spectrum antibiotics within the preceding month, 12 (92%) within three months, and 8 (62%) within six months. Candida species were the only fungal species isolated from the dialysate with predominance of non-albicans Candida species (especially Candida parapsilosis). Therapeutic approach was immediate catheter removal, followed by systemic antifungal therapy and temporary haemodialysis. Nine patients (64.3%) were continued on haemodialysis, whereas five patients (35.7%) died.

Conclusions: Prior antibiotic use was an important risk factor predisposing patients to the development of fungal peritonitis. Early detection of fungal peritonitis would lead to early institution of appropriate therapy and prevention of complications.

Author Biographies

Fahmi Yousef Khan, Hamad General Hospital, Doha, Qatar

Consultant

Department of medicine/Hamad General Hospital

Mohammed Elsayed, Hamad General Hospital, Doha, Qatar

Specialist, nephrology division, Department of medicine

Hamad General Hospital

 

Deshmukh Anand, Hamad General Hospital, Doha, Qatar

Specialist, microbiology

Hamad General Hospital

Mohammed Abu Khattab, Hamad General Hospital, Doha, Qatar

Specialist, infectious disease division, department of medicine

Hamad General Hospital
Doiphode Sanjay, Hamad General Hospital, Doha, Qatar

Consultant, microbiology

Hamad General Hospital
Published
2011-07-05
How to Cite
1.
Khan FY, Elsayed M, Anand D, Abu Khattab M, Sanjay D (2011) Fungal peritonitis in patients undergoing continuous ambulatory peritoneal dialysis in Qatar. J Infect Dev Ctries 5:646-651. doi: 10.3855/jidc.1519
Section
Original Articles