I had to quit PD after getting four nasty, hard-to-kill peritonitis infections. When I returned to hemo, I got a nasal swab for a suspected sinus infection, and it was discovered that I had a colony of staph in my left nostril. I wish I had been tested for staph before I started PD-- I could have avoided two hospitalizations and two painful drains in my abdomen. Wouldn't it be better to test prospective PD patients BEFORE they get peritonitis? If I had known that I'd be contaminating my catheter every time I uncapped it, I would have stayed on hemo!

Dialyxin Dan,

Our PD nurse instructed us to always wear a mask when we are exposing our catheter. Anyone in the room with you must also wear a mask. This is specifically to prevent staff infection caused by staff bacteria often carried in a person's nostrils. I wish you had been instructed to do the same. I have had one very horrible case of peritonitis and know what a painful experience it is. I truly feel for you and wish you all of the luck in the world.

PERITONITIS IS A MAJOR COMPLICATION OF PERITONEAL DIALYSIS. PERITONITIS

PERITONITIS is a major complication of PD. An elevated dialysate count of white blood cells (WBC) of more than 100/mm3.It means it is a sign of Peritonitis.
It means it is a sign of Peritonitis.
In this sign first of all peritoneal fluid will be cloudy and patient feel abdominal pain, vomiting, diarrohea and tenderness.
In the starting of Peritonitis I want to tell you about the microorganism who becomes the cause of Peritonitis.

Microorganisms

Gram Positive : - Staphylococcus epidermis, Staphylococcus aureus, Streptoccocus,
Gram Negative: - Pseudomonas, Enterobacter, E-colli,
Fungi : - Other Organisms, Culture negative

I am sharing with you, I read in one book.
Peritonitis rates due to Staphylococcus epidermis have decreased with the introduction of the Y-set and Flush before fill.
The initial treatment of Peritonitis is empiric and cover both Gram Positive and Gram Negative. In this situation a first generation Cephalosporin such as Cafazolin used in conjunction with amino glycosides (Amikacin) or third generation Cephalosporin we can give. The use of Cephalosporin or Vancomycin to provide Gram Positive coverage and Ceftazidime or amino glycosides for Gram negative coverage. There is the potential problem with the first generation Cephlasporins that they may not adequately cover methicillin-resistant organism in this time we should use of Vancomycin.Because of the concern about the emergence of Vancomycin-resistant organism unnecessary use of Vancomycin should be avoided. Antibiotics usually given I.V or intraperitoneally in a long dwell exchange or orally.
Empirical antibiotics must cover both gram positive and gram negative organisms.
Gram-positive organisms may be covered by vancomycin or a cephalosporin, and gram negative organisms by a third generation cephalosporin or aminoglycoside.Gram Positive
Infections had significantly higher resolution rate, St Aureus had a poorer resolution rate than other Gm pos infections.Non pseudomonal peritonitis had a better outcome than pseudomonas peritonitis.

PREVENT OF PERITONITIS
We can reduce chance of Peritonitis using sterile technique, Use of mask and very important think Flush before fill.

PERITONEAL CATHETER INFECTION
Peritoneal catheter infections can involve the exit site (erythema or pruluent drainage from the exit site) and the tunnel (edema,erythema, or tenderness over the subcutenous pathway).St Aureus is the most common cause of exit site and tunnel infection,with pseudomonas infection the next most frequent organism.St Aureas exit site infection difficult to treat with frequent progression to tunnel infections and peritonitis,in that case catheter removal is required for resolution.St Aureas nasal carriage is associated with an increased risk of St Aures catheter infections.