Peritonitis by gram negative organisms, particularly pseudomonas (P), suggest intraabdominal pathology necessitating early removal of catheter and/or abdominal exploration.
We compared the clinical manifestations and the outcomes between 46 episodes of gram negative and 100 episodes of gram positive peritonitis that occurred within the past 2 years.
Gram negative peritonitis was caused by P. aeruginosa (12 episodes), acinetobacter (8), Serratia (7), other P. species (6). E. coli (4), Klebsiella (3) and others (2). Gram positive peritonitis was caused by S. aureus (43 episodes), S. epidermis
(38),
Streptococcus (8), and others (11).
Gram negative peritnitis was associated with significantly higher initial leukocyte count of drained dialysate, higher incidence of admission to hospitial, catheter remoal, serious complication, i.e. sepsis, intraabdominal abscess and intestinal
obstruction, and death when compared to gram positive peritonitis.
P. aeruginosa peritonitis was associated with significantly higher incidence of fever, serious complications, catheter removal and death when compared to other gram negative peritonitis.
In conclusion. Gram negative peritonitis in general and P. aeruginosa peritonitis in particular is associated with significantly higher morbidity and mortality than periotonitis by gram positive organisms.
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