{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:19:18Z","timestamp":1784420358307,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The number of elderly patients on peritoneal dialysis (PD) has rapidly increased in the past few decades. We sought to explore the microbiology and outcomes of peritonitis in elderly PD patients compared with younger PD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective study to analyze the clinical characteristics, causative organism distribution, and outcome of all PD patients who developed peritonitis between September 1, 2014 and December 31, 2020, from Second Xiangya Hospital, Central South University, China. Patients who experienced peritonitis were separated into elderly and younger groups. The elderly was defined as \u2265 65 years old at the initiation of PD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1,200 patients, 64(33.9%) in elderly (<jats:italic>n<\/jats:italic> = 189) and 215 (21.3%) in younger (<jats:italic>n<\/jats:italic> = 1,011) developed at least one episode of peritonitis. A total of 394 episodes of peritonitis occurred in 279 patients. Of these, 88 episodes occurred in 64 elderly patients, and 306 episodes occurred in 215 younger patients. Gram-positive bacteria were the main causative organisms in elderly and younger patients (43.2% and 38.0%, respectively). Staphylococcus and Escherichia coli were the most common gram-positive and gram-negative bacteria, respectively. Fungal peritonitis in elderly patients was higher compared with younger patients (\u03c72 = 6.55, <jats:italic>P<\/jats:italic> = 0.01). Moreover, Acinetobacter baumannii (\u03c7 <jats:sup>2<\/jats:sup>=9.25, <jats:italic>P<\/jats:italic> = 0.002) and polymicrobial peritonitis (\u03c7 <jats:sup>2<\/jats:sup> = 6.41, <jats:italic>P<\/jats:italic> = 0.01) in elderly patients were also significantly higher than that in younger patients. Additionally, elderly PD patients had higher peritonitis-related mortality than younger patients (\u03c7 <jats:sup>2<\/jats:sup> = 12.521, <jats:italic>P<\/jats:italic> = 0.000), though there was no significant difference in catheter removal between the two groups. Kaplan-Meier analysis showed that cumulative survival was significantly lower in elderly patients than younger patients (log rank = 7.867, <jats:italic>p<\/jats:italic> = 0.005), but similar technical survival in both groups (log rank = 0.036, <jats:italic>p<\/jats:italic> = 0.849).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This retrospective study demonstrated that elderly PD patients were more likely to develop Acinetobacter baumannii, fungal and polymicrobial peritonitis than younger PD patients. In addition, peritonitis-related mortality was significantly higher in elderly patients, whereas peritonitis-related catheter removal was comparable between elderly and younger PD patients. Understanding microbiology and outcome in elderly patients will help to reduce the incidence of PD-associated peritonitis and improve the quality of life.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.799110","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T08:59:20Z","timestamp":1649926760000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Microbiology and Outcome of Peritoneal Dialysis-Related Peritonitis in Elderly Patients: A Retrospective Study in China"],"prefix":"10.3389","volume":"9","author":[{"given":"Panai","family":"Song","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jine","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Zhuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongqing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinghong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1038\/nrneph.2016.181","article-title":"Changes in the worldwide epidemiology of peritoneal dialysis","volume":"13","author":"Li","year":"2017","journal-title":"Nat Rev Nephrol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1681\/ASN.2011060607","article-title":"Global trends in rates of peritoneal dialysis","volume":"23","author":"Jain","year":"2012","journal-title":"J Am Soc Nephrol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1093\/ndt\/gfv411","article-title":"Dialysis modality choice in elderly patients with end-stage renal disease: a narrative review of the available evidence","volume":"32","author":"Segall","year":"2017","journal-title":"Nephrol Dial Transplant."},{"key":"B4","doi-asserted-by":"publisher","first-page":"3755","DOI":"10.1093\/ndt\/gfq212","article-title":"Broadening Options for Long-term Dialysis in the Elderly (BOLDE): differences in quality of life on peritoneal dialysis compared to haemodialysis for older patients","volume":"25","author":"Brown","year":"2010","journal-title":"Nephrol Dial Transplant."},{"key":"B5","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1053\/j.ajkd.2017.10.017","article-title":"Center Effects and Peritoneal Dialysis Peritonitis Outcomes: Analysis of a National Registry","volume":"71","author":"Htay","year":"2018","journal-title":"Am J Kidney Dis."},{"key":"B6","doi-asserted-by":"publisher","first-page":"425","DOI":"10.5812\/numonthly.1825","article-title":"End-Stage Renal Disease and Renal Replacement Therapy in older Patients","volume":"4","author":"Smyth","year":"2012","journal-title":"Nephrourol Mon."},{"key":"B7","doi-asserted-by":"publisher","first-page":"135","DOI":"10.2215\/CJN.02060508","article-title":"Impact of age on peritonitis risk in peritoneal dialysis patients: an era effect","volume":"4","author":"Nessim","year":"2009","journal-title":"Clin J Am Soc Nephrol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"291","DOI":"10.3747\/pdi.2014.00154","article-title":"Is Peritonitis Risk Increased in Elderly Patients on Peritoneal Dialysis? 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