{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:47:54Z","timestamp":1786373274606,"version":"build-2736575974"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>International guidelines suggest a target culture-negative peritonitis rate of &lt;15% among patients receiving long-term peritoneal dialysis. Through a pediatric multicenter dialysis collaborative, we identified variable rates of culture-negative peritonitis among participating centers. We sought to evaluate whether specific practices are associated with the variability in culture-negative rates between low\u2013 and high\u2013culture-negative rate centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>Thirty-two pediatric dialysis centers within the Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) collaborative contributed prospective peritonitis data between October 1, 2011 and March 30, 2017. Clinical practice and patient characteristics were compared between centers with a \u226420% rate of culture-negative peritonitis (low-rate centers) and centers with a rate &gt;20% (high-rate centers). In addition, centers completed a survey focused on center-specific peritoneal dialysis effluent culture techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the 5.5 years of observation, 1113 patients had 1301 catheters placed, totaling 19,025 patient months. There were 620 episodes of peritonitis in 378 patients with 411 catheters; cultures were negative in 165 (27%) peritonitis episodes from 125 (33%) patients and 128 (31%) catheters. Low-rate centers more frequently placed catheters with a downward-facing exit site and two cuffs (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), whereas high-rate centers had more patients perform dialysis themselves without the assistance of an adult care provider (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). The survey demonstrated that peritoneal dialysis effluent culture techniques were highly variable across centers. No consistent practice or technique helped to differentiate low- and high-rate centers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Culture-negative peritonitis is a frequent complication of maintenance peritoneal dialysis in children. Despite published recommendations for dialysis effluent collection and culture methods, great variability in culture techniques and procedures exists among individual dialysis programs and respective laboratory processes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.09190620","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T13:00:39Z","timestamp":1610974839000},"page":"233-240","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Variability in Culture-Negative Peritonitis Rates in Pediatric Peritoneal Dialysis Programs in the United States"],"prefix":"10.2215","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8207-1552","authenticated-orcid":false,"given":"T. Keefe","family":"Davis","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pedatric Nephrology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina A.","family":"Bryant","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Rodean","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Association, Lenexa, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy","family":"Richardson","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Association, Lenexa, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rangaraj","family":"Selvarangan","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Children's Mercy Kansas City, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5953-7812","authenticated-orcid":false,"given":"Xuan","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Division of Microbiology, Seattle Children\u2019s, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Neu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley A.","family":"Warady","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Nephrology, Children's Mercy Kansas City, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,1,18]]},"reference":[{"issue":"Suppl 2","key":"B1-20241015","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.3747\/pdi.2011.00091","article-title":"Consensus guidelines for the prevention and treatment of catheter-related infections and peritonitis in pediatric patients receiving peritoneal dialysis: 2012 update","volume":"32","author":"Warady","year":"2012","journal-title":"Perit Dial Int"},{"key":"B2-20241015","doi-asserted-by":"crossref","first-page":"481","DOI":"10.3747\/pdi.2016.00078","article-title":"ISPD peritonitis recommendations: 2016 update on prevention and treatment","volume":"36","author":"Li","year":"2016","journal-title":"Perit Dial Int"},{"key":"B3-20241015","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1007\/s00467-014-2891-7","article-title":"Design of the Standardizing Care to Improve Outcomes in Pediatric End Stage Renal 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