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

Abstract 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 vir...

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Autores principales:	Ana Claudia Moro Lima dos Santos, Rodrigo Tavanelli Hernandes, Augusto Cezar Montelli, Aydir Cecília Marinho Monteiro, Thais Alves Barbosa, Carlos Henrique Camargo, Adriano Martison Ferreira, Alessandro Lia Mondelli, Maria de Lourdes Ribeiro de Souza da Cunha, Pasqual Barretti
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/24537c6bc7134802874fa0c7decc8bb5
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spelling	oai:doaj.org-article:24537c6bc7134802874fa0c7decc8bb52021-12-02T17:34:40ZClinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis10.1038/s41598-021-91410-02045-2322https://doaj.org/article/24537c6bc7134802874fa0c7decc8bb52021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91410-0https://doaj.org/toc/2045-2322Abstract 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.Ana Claudia Moro Lima dos SantosRodrigo Tavanelli HernandesAugusto Cezar MontelliAydir Cecília Marinho MonteiroThais Alves BarbosaCarlos Henrique CamargoAdriano Martison FerreiraAlessandro Lia MondelliMaria de Lourdes Ribeiro de Souza da CunhaPasqual BarrettiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ana Claudia Moro Lima dos Santos Rodrigo Tavanelli Hernandes Augusto Cezar Montelli Aydir Cecília Marinho Monteiro Thais Alves Barbosa Carlos Henrique Camargo Adriano Martison Ferreira Alessandro Lia Mondelli Maria de Lourdes Ribeiro de Souza da Cunha Pasqual Barretti Clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis
description	Abstract 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.
format	article
author	Ana Claudia Moro Lima dos Santos Rodrigo Tavanelli Hernandes Augusto Cezar Montelli Aydir Cecília Marinho Monteiro Thais Alves Barbosa Carlos Henrique Camargo Adriano Martison Ferreira Alessandro Lia Mondelli Maria de Lourdes Ribeiro de Souza da Cunha Pasqual Barretti
author_facet	Ana Claudia Moro Lima dos Santos Rodrigo Tavanelli Hernandes Augusto Cezar Montelli Aydir Cecília Marinho Monteiro Thais Alves Barbosa Carlos Henrique Camargo Adriano Martison Ferreira Alessandro Lia Mondelli Maria de Lourdes Ribeiro de Souza da Cunha Pasqual Barretti
author_sort	Ana Claudia Moro Lima dos Santos
title	Clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis
title_short	Clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis
title_full	Clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis
title_fullStr	Clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis
title_full_unstemmed	Clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis
title_sort	clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/24537c6bc7134802874fa0c7decc8bb5
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Clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis

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