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Saudi Journal of Kidney Diseases and Transplantation
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ORIGINAL ARTICLE Table of Contents   
Year : 2007  |  Volume : 18  |  Issue : 4  |  Page : 565-570
Rates and Causes of Peritonitis in a National Multicenter Continuous Ambulatory Peritoneal Dialysis Program in Sudan: First-year Experience

1 Chairman of the Program, National Ribat University Hospital, Sudan
2 National Ribat University Hospital, Sudan
3 Khartoum Renal Center, Sudan
4 Military Hospital, Sudan
5 Soba University Hospital, Sudan
6 Jaafar Ibn Auf Pediatric Hospital, Sudan
7 Ibn Sina Specialized Hospital, Sudan

Correspondence Address:
Hasan Abu-Aisha
National Ribat University, Academic Office, Burri, P.O. Box 55, Khartoum
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Source of Support: None, Conflict of Interest: None

PMID: 17951944

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This is a cumulative report of all patients in six centers in Greater Khartoum, all three cities that comprise the capital of Sudan, covering the first year of operation of the National Program. This study evaluates the rates, mechanisms, causative agents and clinical outcomes of peritonitis. We included the data of all 60 patients who underwent CAPD from June 2005 to June 2006. There were 15 episodes of peritonitis in 323 patient-months, which equates to an overall peritonitis rate of one episode every 21.5 months (0.55 episodes per year at risk). The individual center rates varied. There was a statistically significant age difference, with peritonitis being more common in the youngsters. All patients presented with abdominal pain and had cloudy effluents but none had a significant exit site or tunnel infection. Fluid cultures were available in 11 out of the 15 episodes of peritonitis. The cultures were positive for organisms in only 3 out of 11 (27%) cases. Two patients were infected by Pseudomonas aerogenosa and one patient by Staphylococcus aureus. Thus, the culture-negative peritonitis rate was 8/11 (73%). Touch contamination was the likely mechanism in 7/15 (46.7%) of the episodes. There were three cases of refractory peritonitis and only one case of relapsing peritonitis. None of the patients had a catheter removed because of peritonitis. We conclude that the first year of operation of the Sudan National Multi-centered PD program has proven that it is a promising project with multifaceted success. The cumulative peritonitis incidence is acceptable although there are several areas for improvement. Standardized laboratory techniques need to be implemented and pursued, particularly in the microbiology area.

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