Is the Distribution of Microorganisms and Peritonitis Affected by Seasonality in Peritoneal Dialysis?

Abstract

Introduction: Peritonitis continues to be the main complication for patients on peritoneal dialysis (PD). Objective: To determine the frequency of peritonitis according to the disease-causing microorganism and its distribution throughout the year, linking to seasonality. Methods: A retrospective study conducted in the Dialysis Unit of the Hospital S &atilde o Lucas, PUCRS (HSL-PUCRS). Patients undergoing PD between January 1984 and September 2013 were included. Descriptive statistics were used and Fisher’s exact test with Monte Carlo simulation for comparison between the categorical variables. Results: Of 415 evaluated patients, 66% had at least one episode of peritonitis with an incidence rate of 0.68 episode/year. There were 601 peritonitis episodes in total. The most common microorganism was coagulase-negative Staphylococcus (26.6%, n = 160), followed by Staphylococcus aureus (16.3%, n = 98), with 16.3% of the sample being negative culture. Most episodes occurred in the months of January (10.3%, n = 62) and May (10.1%, n = 61), while June had the lowest occurrence (5.2%, n = 31). The number of episodes observed in January and May were significantly higher when compared to June (p < 0.001). No significant differences were found for the remaining months. There was no association between the microorganisms and months of the year (p = 0.841). Conclusion: The rate of peritonitis is in line with that recommended by the International Society for Peritoneal Dialysis. The distribution of peritonitis-causing germs over the months of the year would seem to be random.