Fungal peritonitis in peritoneal dialysis patients: effect of fluconazole treatment and use of the twin-bag disconnect system

Chih-Ming Chen, Mao-Wang Ho, Wen-Liang Yu, Jen-Hsien Wang
Division of Infectious Disease, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, ROC

Received: May 17, 2003 Revised: July 17, 2003 Accepted: August 14, 2003

Corresponding author: Dr. Jen-Hsien Wang, Division of Infectious Disease, Department of Internal Medicine, China Medical University Hospital, No. 2, Yuh Der Road, Taichung, Taiwan 404, ROC. E-mail:

Fungal peritonitis is an uncommon but potentially life-threatening complication for patients undergoing continuous ambulatory peritoneal dialysis. This retrospective study evaluated the efficacy of fluconazole in fungal peritonitis treatment and the incidence of fungal peritonitis in different peritoneal dialysis disconnect systems. Fungal peritonitis was caused by Candida species in 67% of episodes. The most common pathogen in this series was Candida parapsilosis (29%), followed by Candida albicans (14%). One patient (5%) died within 1 month after admission for treatment of fungal peritonitis. Only 1 patient (5%) in this series could resume peritoneal dialysis. Treatment with fluconazole alone has an effect comparable to intraperitoneal (IP) amphotericin B alone or IP amphotericin B combined with oral or intravenous fluconazole. The incidence of fungal peritonitis in patients who used the spike, Y-set, and UV antiseptic systems was 5.69, 6.20, and 2.93 times, respectively, as frequent as that of fungal peritonitis in patients who used the twin-bag disconnect system.

Key words: Dialysis instrumentation, fluconazole, peritoneal dialysis, peritonitis

J Microbiol Immunol Infect 2004;37:115-120.