Staphylococcal peritonitis in patients on continuous peritoneal dialysis

During 1984, 35 patients undergoing continuous peritoneal dialysis experienced 77 cases of peritonitis with 55 cases (71.4%) related to staphylococci. Coagulase-negative staphylococci were isolated in 41 cases, while Staphylococcus aureus was found in 14. A coexisting tunnel infection was more often associated with S. aureus (7/14) than with coagulase-negative staphylococci (2/41) (P < 0.01). Likewise, eradication of the infection necessitated catheter removal more frequently with S. aureus (5/14) than with coagulase-negative staphylococci (2/41) (P < 0.01). Of the 41 coagulase-negative staphylococci, 35 were characterized as to species, adherence, and production of two exopolysaccharides. Staphylococcus epidermidis was the most frequent coagulase-negative species (29/35). Peritonitis cases caused by coagulase-negative staphylococci that lacked adherence and exopolysaccharides were more frequently associated with complications (4/6) than were those organisms with either or both properties of adherence or exopolysaccharide production (5/29). There were no appreciable differences in antibiotic susceptibilities. Staphylococcal peritonitis remains a significant cause of morbidity in continuous peritoneal dialysis patients. The incidence of complications was not directly linked to staphylococcal properties of adherence or exopolysaccharide production.