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SÜREKLİ AYAKTAN PERİTON DÎYALÎZ HASTALARINDA MANTAR PERİTONİTİ GELİŞMESİNDE RİSK FAKTÖRLERİ

RISK FACTORS OF DEVELOPMENT OF FUNGAL PERITONITIS AND ITS OUTCOME IN PATIENTS ON CONTINUOS AMBULATORY PERITONEAL DIALYSIS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1998

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Fungi are important causes of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). The most common causes of fungal peritonitis are Candida albicans or other Candida species.From January 1994 to October 1998 we treated 71 patients with CAPD (a total of 1319 months of treatment). There were 95 episodes of peritonitis (1 case of peritonitis for every 13.88 months of treatment). Four cases of peritonitis were due to a fungal etiology (1 case of peritonitis for every 329,75 months of treatment). Of the patients, three was male, 1 female. The mean age was 30.6, (range 22-54). Diagnosis was established by cultures of dialysis effluent. Of four patients, 2 were diabetic. Three of the patients had received multible antibiotics before the onset of the peritonitis because of either bacterial peritonitis or exit site infection. The cuff of the periton dialysis catheter was not intact in two patients. Serum albumin levels were lower than 3.5mg/dl in all patients before fungal peritonitis. The mean duration of CAPD before fungal peritonitis was 11 months (range 1-36 months). Candida albicans was determined in 2 patients, Acromonium strictum in 1, Candida gillermandi in 1. Our patients were treated with flucasonole/ and amphotericins B according to antibiyogram results. In all patients the catheter was removed. One patients died from sepsis during antifungal therapy. It is suggested that, other systemic diseases and receiving antibiotics are at great risk of suffering from fungal peritonitis.
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Abstract (Original Language): 
Sürekli ayaktan periton diyalizi(SAPD) hastalarında mantar peritonitleri önemli morbidite ve mortalite nedenidir. Mantar peritonitlerinin en sık nedenleri Candida albicans ve diğer Candida suşlarıdır. Ocak 1994-Ekim 1998 tarihleri arasında 71 CAP D hastası izlendi. 95 peritonit epizodu görüldü (Her 13.88 ay basına 1 peritonit olgusu). 4 olgu mantar peritoniti idi. Mantar peritonit/i olguların 3 'ü erkek, 1 'i kadındı ve yas ortalaması 30.6yıl (25-54yıl) idi. Tanı, periton diyaliz sıvısı kültürlerinde mikroorganizmanın üretilmesi ile konuldu. Hastalardan 3 'ü mantar peritoniti tanısından kısa süre önce bakteriyel peritonit veya çıkış yeri enfeksiyonu nedeniyle çeşitli antibiyotikler almıştı. 2 hastanın kateter kafi dışarıda idi. Serum albumin değerleri 3.5 mg/dl altında idi. Bu olgularda ortalama CAP D süresi 11 ay (1-36 ay) idi. İki olguda Candida albicans, 1 'inde Acromonium strictum, 1 'inde de Candida gillermandi saptandı. Antibiyogram sonuçlarına göre flucanosole/ ve amfoterisin B verildi. Periton sıvısının bulanıklığının devam etmesi üzerine 4 hastanın kateterleri çekildi. Hastalardan biri antifungal tedavi sürmekteyken septik şok nedeniyle öldü. Diğer 3 hasta düzenli hemodiyaliz programına alındı. Bakteriyel peritoniti, sistemik hastalığı olan ve antibiyotik alan hastaların mantar peritoniti gelişmesinde risk oluşturdukları görüldü.
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  • 4
202-206
  • Turkish

REFERENCES

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