Kidney research and clinical practice · 2026
Risk factors for multidrug-resistant organisms and their outcomes in peritoneal dialysis-related peritonitis: a multicenter prospective observational study from the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS)-Korea.
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Park Yohan, Shin Jieun, Song Daun, Lee Ji Won, Hwang Won Min, Yun Sung-Ro, Pecoits-Filho Roberto, Bieber Brian, Pisoni Ronald L, Perl Jeffrey, Park Sun-Hee, Kim Yong-Lim, Oh Kook-Hwan, Yoon Se-Hee, PDOPPS-Korea and Arbor Research Investigators
Аннотация
BACKGROUND: Multidrug-resistant organisms (MDROs) present significant challenges in the treatment of peritoneal dialysis (PD)-related peritonitis. This study aimed to describe the incidence, risk factors, and outcomes of MDRO-peritonitis in a national cohort from the PDOPPS (Peritoneal Dialysis Outcomes and Practice Patterns Study)-Korea.
METHODS: Between July 2019 and December 2021, 147 of 292 peritonitis episodes had available data on organism sensitivity and resistance. Episodes were categorized as MDRO-defined as resistance to three or more classes of antibiotics-or non-MDRO. Multivariate logistic regression analysis identified factors associated with MDRO versus non-MDRO peritonitis and predictors of peritonitis cure.
RESULTS: Forty-one of the total 292 peritonitis episodes (14.0%) were identified as MDRO. Prior hospitalization (odds ratio [OR], 32.9; 95% confidence interval [CI], 3.5-313.1), diabetes mellitus (OR, 4.1; 95% CI, 1.2-14.2), and recurrent peritonitis (OR, 48.3; 95% CI, 3.2-735.8) were independent risk factors for MDRO-peritonitis. In the analysis of factors associated with peritonitis cure, longer PD vintage (OR, 0.8; 95% CI, 0.7-1.0) and Gram-negative organisms (OR, 0.1; 95% CI, 0.0-0.4) were associated with lower cure rates, while higher serum albumin level (OR, 1.2; 95% CI, 1.1-1.4) and management at a tertiary referral hospital (OR, 8.8; 95% CI, 1.6-48.0) were associated with higher cure rates. MDRO status itself was not significantly associated with peritonitis cure.
CONCLUSION: Nearly one in seven peritonitis episodes (14.0%) was caused by MDROs. Prior hospitalization, diabetes mellitus, and recurrent peritonitis were independent risk factors for MDRO-peritonitis. Regarding peritonitis cure, characteristics of causative organisms tended to have a greater impact than did MDRO status itself.
METHODS: Between July 2019 and December 2021, 147 of 292 peritonitis episodes had available data on organism sensitivity and resistance. Episodes were categorized as MDRO-defined as resistance to three or more classes of antibiotics-or non-MDRO. Multivariate logistic regression analysis identified factors associated with MDRO versus non-MDRO peritonitis and predictors of peritonitis cure.
RESULTS: Forty-one of the total 292 peritonitis episodes (14.0%) were identified as MDRO. Prior hospitalization (odds ratio [OR], 32.9; 95% confidence interval [CI], 3.5-313.1), diabetes mellitus (OR, 4.1; 95% CI, 1.2-14.2), and recurrent peritonitis (OR, 48.3; 95% CI, 3.2-735.8) were independent risk factors for MDRO-peritonitis. In the analysis of factors associated with peritonitis cure, longer PD vintage (OR, 0.8; 95% CI, 0.7-1.0) and Gram-negative organisms (OR, 0.1; 95% CI, 0.0-0.4) were associated with lower cure rates, while higher serum albumin level (OR, 1.2; 95% CI, 1.1-1.4) and management at a tertiary referral hospital (OR, 8.8; 95% CI, 1.6-48.0) were associated with higher cure rates. MDRO status itself was not significantly associated with peritonitis cure.
CONCLUSION: Nearly one in seven peritonitis episodes (14.0%) was caused by MDROs. Prior hospitalization, diabetes mellitus, and recurrent peritonitis were independent risk factors for MDRO-peritonitis. Regarding peritonitis cure, characteristics of causative organisms tended to have a greater impact than did MDRO status itself.