Abstract: FR-PO475
Influence of Peritoneal Dialysis Solution Type and Strength on Bacterial Growth
Session Information
- Peritoneal Dialysis: Current Topics
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Hong, Annie V., Loma Linda VA Medical Center, Loma Linda, California, United States
- Mishra, Arunima, Loma Linda University Health, Loma Linda, California, United States
- Jang, Soo min, Loma Linda School of Pharmacy, Loma Linda, California, United States
- Infante, Sergio, Loma Linda University School of Medicine, Loma Linda, California, United States
- Fung, Enrica, Loma Linda VA Medical Center, Loma Linda, California, United States
- Perl, Jeffrey, St. Michael's Hospital, Toronto, Ontario, Canada
- Mathew, Roy O., Loma Linda University School of Medicine, Loma Linda, California, United States
- Fletcher, Hansel M., Loma Linda University Health, Loma Linda, California, United States
Background
The role of solution type and strength on peritonitis risk is unclear in patients receiving peritoneal dialysis (PD). We evaluated the in vitro growth characteristics (inhibition or promotion) of common peritonitis bacterial species in various PD solution types.
Methods
Common bacterial pathogens including: Staphylococcus aureus (SA), Staphylococcus epidermidis (SE), Pseudomonas aeruginosa (PA), and Enterococcus faecalis (EF) were cultured in a compatible growth medium overnight (Brain heart infusion, Luria-Bertani broth, or Todd Hewitt broth). An aliquot from the cultures was grown in a 1:1 combination of growth media (control- CON) + PD solution (Baxter: 1.5%, 2.5%, 4.25% dextrose (DEX), and 7.5% icodextrin (ICO)). All cultures were incubated in glass tubes aerobically for 16 h and 20 h at 37 °C; growth at 16h is reported due to minimal increase after that. Bacterial concentrations were measured by optical density of each sample at 600 nm (OD600) and a mean of three independent experiments were taken. The error bars represent the standard deviations.
Results
Compared to control, PA growth was most robust in combined growth media and PD fluid (Figure: growth in PD fluid to growth medium 1:1 mixture at 16h). In particular, PA underwent stronger growth in DEX (p <0.001 DEX vs CON) and grew less in ICO versus all DEX (p = 0.002). In contrast, SA had greater growth in ICO versus all DEX (p < 0.001). EF demonstrated the weakest growth in growth medium + PD fluid.
Conclusion
Common PD-associated bacteria appear to grow similarly in routine PD fluids with the most favorable growth environment for SE. When PD fluids are combined with growth media to better simulate physiologic conditions, ICO limits PA and DEX limits SA growth. Further research is warranted in clinical settings.