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Journal of the Korean Society of Pediatric Nephrology 2012;16(2): 80-88. doi: https://doi.org/10.3339/jkspn.2012.16.2.80
소아 복막 투석 환자에서 발생한 복막염 : 단일기관에서 12년간의 경험
오성희, 이윤정, 이진아, 이주훈, 박영서
1울산대학교 의과대학 서울아산병원 소아청소년병원 소아청소년과
2울산대학교 의과대학 서울아산병원 소아청소년병원 소아청소년과
3울산대학교 의과대학 서울아산병원 소아청소년병원 소아청소년과
4울산대학교 의과대학 서울아산병원 소아청소년병원 소아청소년과
5울산대학교 의과대학 서울아산병원 소아청소년병원 소아청소년과
Peritoneal Dialysis-related Peritonitis in Children: A Single Center's Experience Over 12 Years
Seong Hee Oh, Yoon Jung Lee, Jina Lee, Joo Hoon Lee, Young Seo Park
1Department of Pediatrics, Asan Medical Center, Children's Hospital, University of Ulsan College of Medicine
2Department of Pediatrics, Asan Medical Center, Children's Hospital, University of Ulsan College of Medicine
3Department of Pediatrics, Asan Medical Center, Children's Hospital, University of Ulsan College of Medicine
4Department of Pediatrics, Asan Medical Center, Children's Hospital, University of Ulsan College of Medicine
5Department of Pediatrics, Asan Medical Center, Children's Hospital, University of Ulsan College of Medicine
Received: September 9, 2012;  Revised: September 19, 2012.  Accepted: October 17, 2012.
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ABSTRACT
Purpose: The aim of our study was to investigate the characteristics of the peritoneal dialysis (PD) - related peritonitis and to evaluate the effectiveness of the empirical antibiotics recommended by the International Society for Peritoneal Dialysis in Korean children.
Methods: We retrospectively reviewed the medical records of 72 children on peritoneal dialysis at the Department of Pediatrics, Asan Medical Center over the period from March 2000 to February 2012.
Results : Seventy-nine episodes of peritonitis occurred in 32 patients. The incidence of peritonitis was 0.43 episodes/patient year. There were no significant differences in the incidence of peritonitis in terms of dialysis modality (P=0.459). Twenty-one patients experienced 51 catheter exit-site infections (0.28 episode/patient year). There were no significant differences in the incidence of peritonitis between those with and without history of exit-site infections (P=0.721). Specific pathogens were isolated from 68.4% (54/79) of the patient with peritonitis episodes, including Gram-positive bacteria (n=34), Gram-negative bacteria (n=25) and fungus (n=1). Among Gram-positive bacteria, 85.3% of the isolates were susceptible to ${beta}$-lactam antibiotics, among Gram-negative rods, 94.7% of the isolates were susceptible to ceftazidime. Among 25 cases with unknown etiologies, 92.0% of cases demonstrated satisfactory responses to cefazolin and ceftazidime.
Conclusions : The incidence of peritonitis was 0.43 episodes/patient year. Initial empirical therapy consisting of cefazolin and ceftazidime was appropriate for 91.1% of the PD-related peritonitis treatment. Continuous monitoring for the emergence of the resistant organisms is an important part of the appropriate managements of PD-related peritonitis.
Key words: Peritoneal dialysis | Peritonitis | Children | Korea
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