Incidence and Microbiological spectrum of Peritonitis in Continuous Ambulatory Peritoneal Dialysis Patients: A Retrospective Study

Abstract Introduction: Peritonitis is a major complication and the leading cause of technique failure in continuous ambulatory peritoneal dialysis (CAPD). While numerous factors influence its incidence, the specific microorganisms isolated largely determine clinical outcomes. This study aimed to assess the incidence rate, microbiological spectrum, and antibiotic sensitivity patterns of peritonitis in CAPD patients at a single tertiary care center. Methods: We retrospectively analyzed patients who developed peritonitis while on CAPD between 1st January 2022 to 31st december 2023. Peritonitis was defined according to the International Society for Peritoneal Dialysis guidelines. Baseline demographic data, etiologies of chronic kidney disease (CKD), and clinical outcomes were recorded. Dialysate samples underwent standard culture and sensitivity testing Results: A total of 34 peritonitis episodes occurred in 32 CAPD patients (mean age 52.7 ± 10.0 years; mean CAPD duration 28 ± 6.2 months), corresponding to a peritonitis rate of 0.36 episodes per patient-year. Of these, 26 episodes (76.47%) were culture-positive, with Gram-positive organisms (especially Staphylococcus aureus and coagulase-positive staphylococci) predominating (16/26). Gram-negative isolates included Escherichia coli, Pseudomonas spp., and ESBL-producing Klebsiella pneumoniae. Conclusion: Staphylococci remained the most common pathogens in CAPD peritonitis, although Gram-negative, fungal, and mycobacterial infections pose significant diagnostic and therapeutic challenges. Prompt detection, including specialized tests for mycobacteria, along with robust infection control practices and appropriate antibiotic stewardship, are essential to improve CAPD outcomes