Fungal peritonitis in patients on CAPD from a tertiary care hospital in South India- 5 years (2008-2012) review

Padmasri. C*. Umabala P, Sandhya Devi K S and Lakshmi V

Author address: 

Department of Microbiology, Nizam's Institute of Medical Sciences, Panjagutta,Hyderabad-500 082,Andhra Pradesh

Abstract: 

The objective of the study was to retrospectively review the aetiology, clinical presentation, management and outcome of fungal peritonitis. All patients with fungi isolated from the CAPD fluid and or CAPD catheter tip during the period from January 2008 to December 2012 were identified from the microbiology lab records and their medical records were reviewed. The diagnosis of peritonitis was based on abdominal pain, cloudy peritoneal effluent with an elevated leukocyte count. A total of 57 patients were diagnosed with fungal peritonitis during the 5 year period. One patient had a mixed infection with Aspergillus flavus and lichthemia corymbifera. Fever, abdominal pain and cloudy dialysate effluent were the most common presenting features. Yeasts constituted 45% (26 of 58) and moulds 55% (32 of 58) of the fungal isolates. Non albicans Candida species which included C. tropicalis (n=8), C. parapsilosis (n=6), C. guilliermondii (n=l) and unidentified NAC species (n=- 2) constituted the majority (81%) of the Candida species isolated, whereas as Candida albicans was isolated from only 4 patients. Other yeasts isolated were Trichosporon asahii, Trichosporon mucoides.Kodamea ohmeri and Cryptococcus laurentii. Of the moulds isolated, different species of Aspergillus (n= 23) were most common: A. flavus (n=15), A. fumigates (n= 1), A.terreus (n= 1), A. niger (n=l), unidentified Aspergillus species (n=-5). Other moulds isolated were Lichthemia corymbifera along with A. flavus, Acremonium sp., Fusarium sp., Simplicillium obclavatum and non sporulating moulds. A wide spectrum of fungi, some very rarely reported from human infections are being identified as a cause of fungal peritonitis in CAPD patients. Non albicans Candida species and moulds especially Aspergillus flavus seem to predominate over Candida albicans as the cause of fungal peritonitis. 9830;Corresponding author E-mail: [email protected]
2014

abstract No: 

OP-023

Full conference title: 

Society for Indian Human and Animal Mycologists 2014
    • SIHAM