Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0341503 (bacterial peritonitis)
 1,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report three cases of fungal peritonitis in patients undergoing CAPD, representing 1.3% of 228 episodes recorded during an 8 year period. The three patients, who had been catheterized for a long time, had previous episodes of bacterial peritonitis and had received antibiotic therapy. The culture was decisive to make the diagnosis. The change of the catheter and the treatment with antifungal agents contributed to cure the infection, although the three patients died from other causes. One case of peritonitis was caused by Candida lusitaniae.
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PMID:[Fungal peritonitis during continuous ambulatory peritoneal dialysis (CAPD)]. 202 56

Forty six patients who developed 48 episodes of peritonitis while on CAPD were randomised to receive either oral ofloxacin or intraperitoneal (i.p.) vancomycin/aztreonam. Three patients were excluded from analysis: 2 were transferred to other hospitals and 1 was later found to have candida peritonitis. Of the remainder, 22 episodes were treated with oral ofloxacin and 23 with i.p. vancomycin/aztreonam. The primary cure rate in the oral ofloxacin and i.p. vancomycin/aztreonam group was 77.3% and 87.5% respectively. There were 3 primary failures and 2 relapses in the former and 1 failure and 2 relapses in the latter group. Two of the 4 primary failures were peritonitis episodes secondary to infection with pseudomonas species. The total number of days of hospital stay was 48 and 58 respectively in the two groups. Analysis of the cost of treatment revealed that i.p. vancomycin/aztreonam was 30 times more expensive than oral ofloxacin. Despite a slightly higher cure rate with i.p. vancomycin/aztreonam, oral ofloxacin is a more cost-effective primary treatment of bacterial peritonitis in patients on CAPD especially in countries with a limited health budget.
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PMID:A randomised prospective comparison of oral ofloxacin and intraperitoneal vancomycin plus aztreonam in the treatment of bacterial peritonitis complicating continuous ambulatory peritoneal dialysis (CAPD). 204 19

Nontuberculous mycobacteria (NTM) are responsible for an increasing proportion of mycobacterial disease. Peritonitis due to NTM is an unusual but treatable complication of continuous ambulatory peritoneal dialysis (CAPD). Its presentation is similar to that of typical bacterial peritonitis, but special culture techniques are required to avoid a delay in diagnosis. Successful treatment depends on early catheter removal, drainage of fluid collections, and appropriate use of antimicrobial agents. We report a case of Mycobacterium fortuitum peritonitis in a patient undergoing CAPD, and review all previously reported cases. Diagnostic and therapeutic strategies are summarized based on available literature.
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PMID:Nontuberculous mycobacterial peritonitis during continuous ambulatory peritoneal dialysis: case report and review of diagnostic and therapeutic strategies. 206 47

Asymptomatic bacterascites is defined as the presence of bacteria in ascitic fluid without clinical features of peritonitis or increased ascitic fluid polymorphonuclear cells. Asymptomatic bacterascites is a controversial entity, and little information is available regarding its spontaneous evolution. Clinical features, bacteriological data and outcome in 22 cirrhotic patients with asymptomatic bacterascites are reported and are compared with those of a group of 36 cirrhotic patients with spontaneous bacterial peritonitis. Eleven patients had gram-negative bacteria and 11 had one gram-positive bacteria. Only in three patients (13.6%) did peritonitis develop. Twelve patients received no antibiotic therapy, and in none did peritonitis develop. At 1 month, 27% of patients with asymptomatic bacterascites had died. Patients with asymptomatic bacterascites had less-severe liver disease; they more frequently had gram-positive bacteria in ascitic fluid and had a lower 1-mo mortality rate than did patients with spontaneous bacterial peritonitis. We conclude that asymptomatic bacterascites is usually the transient residence of bacteria in ascitic fluid. Peritonitis rarely develops in patients with asymptomatic bacterascites and, in most of them, antibiotic therapy is not required.
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PMID:Asymptomatic bacterascites: is it spontaneous bacterial peritonitis? 206 60

Relapsing peritonitis due to Mycobacterium xenopi developed in an 80-year-old man undergoing continuous peritoneal dialysis after appropriately treated concurrent bacterial peritonitis. The patient presented with a lymphocytic exudative peritoneal drainage fluid. The diagnosis of tuberculous peritonitis was made by identification of acid-fast bacilli in peritoneal effluent and culture of M. xenopi. Oral antituberculous drugs in combination with intraperitoneal streptomycin achieved suppression of the disease, permitting peritoneal dialysis to be continued with satisfactory clearance and ultrafiltration capacity during a follow-up period of up to 35 months. Streptomycin kinetics revealed that 75% of the intraperitoneally administered dose of streptomycin is absorbed from the dialysate.
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PMID:Streptomycin pharmacokinetics in relapsing Mycobacterium xenopi peritonitis. 208 Jul 96

We studied fifty seven episodes of cirrhotic spontaneous bacterial peritonitis in order to know its microbiological, clinical and evolutive characteristics. One third of the patients had presented some previous peritonitis episodes. Ninety three percent of the patients referred some symptoms at time of diagnosis. Ascitic fluid Gram stain showed the presence of bacteria in 72% of the samples. Culture of ascitic fluid was positive for a single microorganism in 50 cases (88%). Seventy seven percent of microorganisms were Gram negative being Escherichia Coli in 63% of cases. Hemoculture was positive in 68% of cases with an almost complete correspondence with germs found in ascites. Seventy four percent of patients presented some complication throughout their hospital stay being the most frequent renal failure (49%) and encephalopathy (46%). Sixty three percent of patients died being the mortality rate higher amongst the older patients and amongst those who did not present neither high temperature or peritonism, or those who developed some complication.
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PMID:[A microbiological and clinical study of 57 cases of spontaneous bacterial peritonitis in liver cirrhosis patients]. 209 Nov 10

In the study 52 patients with decompensated liver cirrhosis and "tense" ascites were included. According to the clinical picture, ascites cultures and the number of polymorphonuclears in cmm of the ascitic fluid, all patients were selected in one of the following groups: 1. group of patients with sterile ascites (28), 2. group of patients with spontaneous peritonitis (16), and 3. group of patients with bacterascites (8). The results have shown that the incidence of spontaneous peritonitis is much higher in the group of "tense" ascites patients than in the group of all patients with ascites, the ratio being 30.7% compared to 6% in all cirrhotic patients with ascites. Spontaneous bacterial peritonitis correlates with increased polymorphonuclears in the ascitic fluid (p less than 0.05), decreased pH values (p less than 0.0), and increased amounts of total proteins in the ascitic fluid (p less than 0.05). The lethality rate in the group of spontaneous peritonitis and sterile ascites was 43.7% and 7.1% respectively. Early diagnosis and, of course, adequate therapy are the main points in spontaneous bacterial peritonitis.
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PMID:[Spontaneous bacterial peritonitis in patients with decompensated liver cirrhosis and "tense" ascites]. 209 34

The fixed combination antibiotic ampicillin/sulbactam may provide a new, safe, and effective method of treating dialysis-related bacterial peritonitis. The pharmacokinetics of this antibiotic combination were determined in patients receiving continuous ambulatory peritoneal dialysis (CAPD). The pharmacodynamic activity of this drug was also determined by use of mean bactericidal titers against selected bacterial strains. Six noninfected CAPD patients in a randomized two-way crossover study were given a fixed dose of ampicillin (2 gm) and sulbactam (1 gm) either intravenously or intraperitoneally. The mean peak ampicillin and sulbactam serum concentrations following intravenous dosing were 170.3 and 87.5 micrograms/mL, respectively. The mean peak serum concentrations of ampicillin and sulbactam following intraperitoneal dosing were 48.0 and 27.8 micrograms/mL, respectively. Absolute bioavailabilities of the intraperitoneal ampicillin and sulbactam doses were 60% and 68%. Both drugs exhibited similar distribution and elimination characteristics. Renal failure markedly reduced drug elimination. Intraperitoneal administration of ampicillin/sulbactam provided satisfactory inhibitory and bactericidal antibiotic titers for most organisms in dialysate at 6 h but not 24 h. Ampicillin/sulbactam (2 gm/1 gm) should be administered every 12 h to patients with peritoneal dialysis-related peritonitis.
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PMID:Ampicillin and sulbactam pharmacokinetics and pharmacodynamics in continuous ambulatory peritoneal dialysis (CAPD). 209 58

Fibrin deposition in response to bacterial peritonitis appears to predispose to residual infection in the peritoneal cavity. Our previous studies have demonstrated that intraperitoneal fibrinolysis using human recombinant tissue plasminogen activator (t-PA) prevented abscess formation in a rat intra-abdominal sepsis model. To investigate the potential adverse side effects of its use in the peritoneal cavity, the effect of t-PA on colonic anastomotic wound healing and on systemic coagulation parameters was examined in the rat. T-PA did not adversely affect colonic healing five and ten days after anastomosis. In animals infected intraperitoneally at the time of the anastomosis, t-PA reversed the inhibition of healing induced by perianastomotic abscesses at five days. This effect was mediated by the ability of t-PA to prevent perianastomotic abscess formation. After intraperitoneal administration, t-PA had no effect on prothrombin and partial thromboplastin times in either uninfected or infected animals and there was no evidence of clinical bleeding related to its use. These studies suggest that intraperitoneal fibrinolysis using t-PA may provide a safe, effective form of adjuvant therapy in the management of fibrinopurulent peritonitis.
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PMID:Tissue plasminogen activator reverses the deleterious effect of infection on colonic wound healing. 210

Tuberculous peritonitis is a rare disease, which often goes unrecognized because of the subtle clinical clues and its insidous onset. We retrospectively analyzed the records of 37 cases of tuberculous peritonitis diagnosed over a 15-year period, and compared the clinical and diagnostic features of cirrhotic and noncirrhotic patients. In cirrhotic patients, tuberculous peritonitis can simulate ascites from liver disease or spontaneous bacterial peritonitis. The diagnosis is difficult in these patients because the ascitic fluid may not be of the exudative type as a result of the low albumin level in serum, and lymphocytes do not predominate in all cases. Adenosine deaminase (ADA) activity in ascitic fluid was elevated (higher than 40 U/L) in all 11 patients (four patients with hepatic cirrhosis). The time required to achieve a correct diagnosis was significantly longer in cirrhotic than in noncirrhotic patients. The overall mortality was 13%, with deaths occurring exclusively among cirrhotic patients. We emphasize that tuberculous peritonitis in cirrhotic patients can present an atypical picture. A considerable element of suspicion is necessary.
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PMID:Tuberculous peritonitis: a study comparing cirrhotic and noncirrhotic patients. 214 14


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