Standardized peritonitis reporting seen as feasible
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Standardized peritonitis reporting in peritoneal dialysis facilities is feasible, according to a presenter at DOPPS.
“Peritonitis is a concerning infectious complication in PD patients, and despite the advancements in peritonitis intervention and treatment, it has remained the leading cause of modality switch among all countries enrolled in the [... Peritoneal Dialysis Outcomes and Practice Patterns Study] PDOPPS,” Muthana Al Sahlawi, MD, assistant professor in the department of medicine at King Faisal University, said in a presentation. “Now, although there is a national surveillance system in the U.S. for catheter-related bacteremia and hemodialysis patients, no similar formal mechanism exists for the reporting of PD peritonitis.”
In the pilot study, Optimizing the Prevention of Peritoneal Dialysis Associated Peritonitis in the United States, researchers developed a web-based peritonitis tracker tool called OPPUS-Link. The tool underwent literature review, stakeholder consultation and International Society for Peritoneal Dialysis (ISPD) guidelines review.
Researchers selected 52 PD facilities (median size was 36 patients) based on geography and peritonitis rates to test OPPUS-Link. All facilities were provided with formal training, a central data review and adjudication of all peritonitis episodes and outcomes. Then, a member of the facility was tasked with recording peritonitis details into OPPIS-Link. Further, all PD units were given a survey regarding the study.
Overall, 442 peritonitis episodes occurred between October 2020 and August 2022; 183 of which were associated with a hospitalization. The peritonitis rate was 0.23 per patient-year, and 24 patients experienced more than one episode during the study.
A survey revealed that all facilities indicated routine recording and tracking of peritonitis episodes, and 100% of medical directors were involved in the review process of PD-related infection rates. Further, 30.5% of facilities included non-medical director physicians and 3% included a microbiologist or an infectious disease specialist.
“Interestingly, none of the facilities involved a pharmacist in this review process,” Al Sahlawi said.
Additionally, 83% of participants said they would recommend the OPPUS tracker tool to other clinics.
Moving forward, Al Sahlawi said the team intends to implement the OPPUS tool to develop a national mechanism for PD peritonitis tracking and reporting. Future research will investigate the effect of different peritonitis preventative strategies and ISPD guideline adherence across PD clinics.
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Al Sahlawi M. Nationwide standardized peritonitis reporting: Results from the Optimizing the Prevention of Peritoneal Dialysis Associated Peritonitis in the United States (OPPUS) pilot study. Presented at: DOPPS; Oct. 21, 2022; virtual meeting.
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