دورية أكاديمية
أعرض في EDS

Best Practice of Peritoneal Dialysis-Associated Gram-Negative Peritonitis in Children: Insights From the International Pediatric Peritoneal Dialysis Network Registry.

التفاصيل البيبلوغرافية
العنوان: Best Practice of Peritoneal Dialysis-Associated Gram-Negative Peritonitis in Children: Insights From the International Pediatric Peritoneal Dialysis Network Registry.
المؤلفون: Borzych-Dużałka D; Department for Pediatrics, Nephrology and Hypertension, Medical University of Gdańsk, Gdańsk, Poland.; University Center for Pediatrics and Adolescent Medicine, Heidelberg, Germany., Same R; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Neu A; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Yap HK; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Verrina E; IRCCS Instituto Giannina Gaslini, Genoa, Italy., Bakkaloglu SA; Gazi University Hospital, Ankara, Turkey., Cano F; Division of Pediatric Nephrology, Hospital Dr. Luis Calvo Mackenna, Facultad de Medicina, Universidad de Chile, Santiago, Chile., Patel H; Nationwide Children's Hospital, Columbus, Ohio, USA., Szczepańska M; Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland., Obrycki Ł; Children's Memorial Health Institute, Warsaw, Poland., Spizzirri AP; Division of Pediatric Nephrology, Hospital for Maria Ludovica, La Plata, Argentina., Sartz L; Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden., Vondrak K; University Hospital Motol, Prague, Czech Republic., Rebori A; SENIAD, Montevideo, Uruguay., Milosevski-Lomic G; Children's University Hospital, Belgrade, Serbia., Chan EY; Pediatric Nephrology Centre, Hong Kong Children's Hospital, Kowloon Bay, Hong Kong SAR., Basu B; NRS Medical College and Hospital, Kolkata, India., Pezo AL; Roberto del Rio Hospital, Chile., Zaloszyc A; Pediatric Nephrology, Pédiatrie 1, Centre Hospitalier Universitaire de Strasbourg, France., Chadha V; Children's Mercy Kansas City, Kansas City, Missouri, USA., Schaefer F; University Center for Pediatrics and Adolescent Medicine, Heidelberg, Germany., Warady BA; Children's Mercy Kansas City, Kansas City, Missouri, USA.
المصدر: Kidney international reports [Kidney Int Rep] 2024 Mar 28; Vol. 9 (6), pp. 1654-1663. Date of Electronic Publication: 2024 Mar 28 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101684752 Publication Model: eCollection Cited Medium: Internet ISSN: 2468-0249 (Electronic) Linking ISSN: 24680249 NLM ISO Abbreviation: Kidney Int Rep Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Philadelphia] : Elsevier, [2016]-
مستخلص: Introduction: Gram-negative peritonitis (GNP) is associated with significant morbidity in children receiving long-term peritoneal dialysis (PD) and current treatment recommendations are based on limited data.
Methods: Analysis of 379 GNP episodes in 308 children (median age 6.9 years, interquartile range [IQR]: 3.0-13.6) from 45 centers in 28 countries reported to the International Pediatric Peritoneal Dialysis Network registry between 2011 and 2023.
Results: Overall, 74% of episodes responded well to empiric therapy and full functional recovery (FFR) was achieved in 82% of cases. In vitro bacterial susceptibility to empiric antibiotics and lack of severe abdominal pain at onset were associated with a good initial response. Risk factors for failure to achieve FFR included severe abdominal pain at onset and at 60 to 72 hours from treatment initiation (odds ratio [OR]: 3.81, 95% confidence interval [CI]: 2.01-7.2 and OR: 3.94, 95% CI: 1.06-14.67, respectively), Pseudomonas spp. etiology (OR: 1.73, 95% CI: 1.71-4.21]) and in vitro bacterial resistance to empiric antibiotics (OR: 2.40, 95% CI: 1.21-4.79); the risk was lower with the use of monotherapy as definitive treatment (OR: 0.40, 95% CI: 0.21-0.77). Multivariate analysis showed no benefit of dual antibiotic therapy for treatment of Pseudomonas peritonitis after adjustment for age, presenting symptomatology, 60 to 72-hour treatment response, and treatment duration. Monotherapy with cefazolin in susceptible Enterobacterales peritonitis resulted in a similar FFR rate (91% vs. 93%) as treatment with ceftazidime or cefepime monotherapy.
Conclusion: Detailed microbiological assessment, consisting of patient-specific and center-specific antimicrobial susceptibility data, should guide empiric treatment. Treatment "deescalation" with the use of monotherapy and narrow spectrum antibiotics according to susceptibility data is not associated with inferior outcomes and should be advocated in the context of emerging bacterial resistance.
(© 2024 International Society of Nephrology. Published by Elsevier Inc.)
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فهرسة مساهمة: Keywords: Enterobacterales; PD-associated peritonitis; Pseudomonas; children; gram-negative
تواريخ الأحداث: Date Created: 20240620 Latest Revision: 20240621
رمز التحديث: 20240621
مُعرف محوري في PubMed: PMC11184244
DOI: 10.1016/j.ekir.2024.03.031
PMID: 38899186
قاعدة البيانات: MEDLINE
الوصف
تدمد:2468-0249
DOI:10.1016/j.ekir.2024.03.031