Efforts to improve the percentage of cultures positive for microorganisms in peritoneal dialysis effluent

KOURA Noriaki, ITO Takuya, ITO Takamitsu

doi:10.14932/jamt.20-116

<p>We performed smears, used two different culture methods (blood culture bottles and agar plates), and studied the isolated bacteria from 55 peritoneal dialysis (PD) effluent samples collected from patients diagnosed with PD-related peritonitis from April 2013 to December 2019. The percentage of gram-positive staining in the smears was 27.2% (15 cases), and the percentage of positive cultures was 81.8% (45 cases), and 58.1% (32 cases) for blood culture bottles, and agar plates, respectively. Thirty-one gram-positive, 23 gram-negative, and 1 fungal strains were isolated. Of note, PD effluent samples were collected by nurses prior to May 2017 (n=43), and by clinical laboratory technicians (n=12) thereafter. Thus, we examined the difference in the percentage of positive cultures before and after this change. The percentage of positive cultures in samples collected by nurses and clinical laboratory technicians were 76.7% (33 cases) and 100% (12 cases), respectively, for blood culture bottles, and 58.1% (25 cases) and 58.3% (7 cases), respectively, for agar plates. These results indicate that the collection of PD effluent samples by clinical laboratory technicians and the use of blood culture bottles improved the detection of microorganisms. Importantly, the identification of the infectious agent is not only important for the selection of appropriate antibacterial drugs but also for the investigation of the route of infection and the education of patients, e.g. revision of the back exchange procedures, and improvement of the home environment and daily life habits.</p>

Efforts to improve the percentage of cultures positive for microorganisms in peritoneal dialysis effluent

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