Risk Factors and Pathogen Spectrum in Continuous Ambulatory Peritoneal Dialysis- Associated Peritonitis: A Single Center Retrospective Study

Background: To investigate the incidence, risk factors, pathogen distribution, and drug resistance patterns in continuous ambulatory peritoneal dialysis-associated peritonitis (CAPDP).Material/Methods: Clinical data for 248 patients who underwent continuous ambulatory peritoneal dialysis (CAPD) treatment in a single center in China from March 2018 to January 2021 were retrospectively collected. The patients were divided into the CAPDP group (n=40) and the non-CAPDP group (n=208) according to whether peritonitis oc-curred. The incidence rate, risk factors, bacterial distribution, and drug sensitivity of CAPDP were analyzed.Results: The incidence of CAPDP was 16.13%, and 87.5% of patients with CAPDP continued CAPDP treatment after an-ti-infection treatment. Patients with and without CAPDP were clearly distinguished, on the basis of their clin-ical characteristics, by using principal component analysis (PCA) methods. Logistic regression analysis found that body mass index (BMI; P=0.0095), albumin (P=0.016), albumin/globulin ratio (P=0.018), C-reactive protein (P=0.0001), and rapid transport (P=0.034) were independent risk factors for CAPDP. The main pathogens caus-ing the CAPDP were Staphylococcus epidermidis (50.00%), Staphylococcus capitis (13.33%), and Escherichia coli (10.00%). Among the pathogenic bacteria, the main drugs to which gram-negative cocci were sensitive were imipenem, meropenem, piperacillin/tazobactam, cefoperazone/sulbactam, ceftazidime, and tigecycline. The main drugs to which gram-positive cocci were sensitive were vancomycin, teicoplanin, and linezolid. The drug resistance rate of pathogenic bacteria to penicillin G, ampicillin, compound trimethoprim, cefepime, ceftriaxone, and amoxi-cillin-clavulanic acid drugs was 36.26-100%.Conclusions: BMI, albumin, albumin/globulin ratio, C-reactive protein, and rapid transport are independent risk factors for CAPDP. Gram-positive bacteria are the main pathogens of CAPDP and are sensitive to vancomycin, teicoplanin, and linezolid.