S.TAN1, R.N.DEEPAK1, S.H.TAN1, G.J.BILBAO1, M.P.BOEY1, S.M.LAU1, M.E.LIAW1, K.LEE1, A.LIU1
Khoo Teck Puat Hospital1
Bacterial peritonitis remains a significant cause of mortality in patients on peritoneal dialysis (PD). Early detection of causative organisms and targeted antimicrobial treatment allow for better clinical outcomes. This study compares bacterial growth results from peritoneal dialysate in the BACTEC blood culture system versus direct inoculation for conventional culture.
We conducted a prospective study of 60 consecutive PD patients for suspected PD peritonitis between August 2020 and July 2021. PD dialysate was simultaneously sent in both BACTEC and sterile bottles. Recovery of isolated microorganisms and time to detection (TTD) were compared.
Twenty-six out of sixty patients were diagnosed with PD Peritonitis based on clinical criteria. The sensitivities of the BACTEC method and the conventional culture method were 46% and 35% respectively (p=0.68). Seven samples had discordant results. McNemar’s Chi-squared test revealed no statistical difference between both methods (p=0.45). TTD was 18.9±24.4 hours via the BACTEC method versus 37±16.5 hours in conventional cultures (p=0.014).
With comparable sensitivities and similar yield in identifying pathogens in PD fluid, the TTD was significantly shorter with the BACTEC method, which may facilitate earlier confirmation of bacteriological diagnosis and the subsequent establishment of treatment strategies.