Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Kolland, M; Ribitsch, W; Prenner, A; Buchgraber, J; Odler, B; Krause, R; Rosenkranz, AR.
Effluent microscopy is a useful adjuvant diagnostic tool in peritoneal dialysis-associated peritonitis.
Clin Nephrol. 2022; 98(1):33-41
Doi: 10.5414/CN110732
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Kolland Michael
- Rosenkranz Alexander
- Co-Autor*innen der Med Uni Graz
- Goritschan Anna
- Krause Robert
- Odler Balazs
- Ribitsch Werner
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- Abstract:
- BACKGROUND: Infectious complications are the leading cause of technical failure in peritoneal dialysis (PD); however, targeted anti-infective therapy is not feasible at the onset, as effluent cultures take days and may be inconclusive. Although recommended by the guidelines, divergent positivity rates of Gram-stained effluent microscopy question the value of its usefulness. This study aimed to evaluate if microscopy of cell types serves as an additional and timely diagnostic approach. MATERIALS AND METHODS: This single-center retrospective analysis included prevalent PD patients (n = 250) between 2007 and 2017. Automated quantitative cell count, cytological analysis of Hemacolor and Gram-stained effluent sediment, and effluent cultures were conducted during peritonitis episodes. We calculated the rate of peritonitis, positivity rate of effluent cultures, and effluent microscopy. RESULTS: There were 155 at-risk cases of peritonitis in 662.7 years during the observation period. The culture positivity rate was 73.5%. In neutrophilic culture-negative peritonitis (CNP), effluent Gram staining yielded the identification of the microbial species in 51.6% cases. In 24.4% of CNP, effluent microscopy showed eosinophilic peritonitis, which occurred with less initial effluent leucocytes and showed better PD survival. CONCLUSION: In PD-associated peritonitis, Gram-stained dialysate with effluent microscopy supplements culture results in CNP. Hemacolor staining is crucial for differentiating eosinophilic peritonitis, showing a divergent clinical course and outcome.
- Find related publications in this database (using NLM MeSH Indexing)
- Dialysis Solutions - administration & dosage
- Humans - administration & dosage
- Microscopy - administration & dosage
- Peritoneal Dialysis - adverse effects
- Peritonitis - diagnosis, drug therapy, etiology
- Retrospective Studies - administration & dosage
- Find related publications in this database (Keywords)
- peritoneal dialysis
- peri-tonitis
- eosinophils
- mi-croscopy
- Gram staining