Peritonitis in Continuous Ambulatory Peritoneal Dialysis: A One-Year Prospective Case Series on Microbiology and Outcomes

This is the authors' abstract. We don't add key points for this paper.

Background: Peritonitis is the leading complication of continuous ambulatory peritoneal dialysis (CAPD), contributing to technique failure and morbidity. Local microbiological data are essential for guiding empiric therapy. Methods: This prospective observational case series included all International Society for Peritoneal Dialysis (ISPD)-defined peritonitis episodes occurring in CAPD patients at a tertiary care center in Northeast India from June 2024 to June 2025. Demographics, microbiology, treatment, and outcomes were recorded. Results: Fourteen peritonitis episodes occurred in 13 patients over 120 patient-years, yielding a rate of 0.12 episodes/patient-year. Cultures were positive in 79% of episodes. Gram-positive organisms predominated (43%), followed by gram-negative organisms (21%) including Pseudomonas aeruginosa, and fungi (14%). Clinical cure was achieved in 71% of episodes. Catheter removal was required in 21%, primarily for fungal and resistant gram-negative infections. Ninety-day mortality was 0%. Conclusion: Our peritonitis rate was well below the ISPD benchmark. Early recognition, protocol adherence, and prompt catheter removal in high-risk infections are key to preserving peritoneal dialysis technique survival.