Clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis

Autor(es)

Moro Lima dos Santos, Ana Claudia ^[1] ; Hernandes, Rodrigo Tavanelli ^[1] ; Montelli, Augusto Cezar ^{[1, 2]} ; Marinho Monteiro, Aydir Cecilia ^[1] ; Barbosa, Thais Alves ^[1] ; Camargo, Carlos Henrique ^[3] ; Ferreira, Adriano Martison ^[4] ; Mondelli, Alessandro Lia ^{[2, 4]} ; Ribeiro de Souza da Cunh, Maria de Lourdes ^[1] ; Barretti, Pasqual ^[2]

Afiliação do(s) autor(es)

^[1] Sao Paulo State Univ Julio de Mesquita Filho UNES, Biosci Inst Botucatu, Botucatu, SP - Brazil

^[2] Sao Paulo State Univ Julio de Mesquita Filho UNES, Botucatu Med Sch, Botucatu, SP - Brazil

^[3] Adolfo Lutz Inst, Sao Paulo - Brazil

^[4] Botucatu Med Sch Clin Hosp, Botucatu, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: SCIENTIFIC REPORTS; v. 11, n. 1 JUN 10 2021.
• Citações Web of Science: 0

Resumo

Peritonitis due to gram-negative bacilli (GNB), particularly nonfermenting GNB (NF-GNB), is a serious complication of peritoneal dialysis with a low resolution rate. Beyond the patient's condition, microbiological properties such as antimicrobial resistance, biofilm production and other virulence factors can explain the poor outcomes. This study aimed to evaluate the influence of patient condition, microbiological characteristics, including biofilm production, and treatment on peritonitis outcome. We reviewed the records of 62 index episodes caused by NF-GNB that occurred between 1997 and 2015 in our center. The etiologies were species of Pseudomonas (51.6%), Acinetobacter (32.2%), and other NF-GNB (16.1%). There was a high (72.9%) proportion of biofilm producer lineages. The in vitro susceptibility rate of Pseudomonas spp. to amikacin, ciprofloxacin, and ceftazidime was significantly greater than that of Acinetobacter spp. and other species; however, there was a similar low resolution rate (<45%) among the episodes attributable to them. Preexisting exit-site infection was independently associated with nonresolution. No other factor, including biofilm production, was associated with the outcome. The higher in vitro susceptibility of Pseudomonas compared to other NF-GNB that presented a similar resolution rate suggests that bacterial virulence factors such as biofilms can act in concert, thereby worsening the outcome. (AU)

• Processo FAPESP: 13/21379-8 - Fatores de virulência de bastonetes Gram negativos e sua influência na evolução das peritonites em diálise peritoneal
• Beneficiário: Pasqual Barretti
• Linha de fomento: Auxílio à Pesquisa - Regular