Abstract: SA-PO459
Incidence and Outcomes of Nontuberculous Mycobacterium Infections in Patients Undergoing Peritoneal Dialysis
Session Information
- Home Dialysis - 2
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Lazar, Rachael, DaVita Inc, Denver, Colorado, United States
- Zywno, Meredith L., DaVita Inc, Denver, Colorado, United States
- Weinhandl, Eric D., Davita Clinical Research, Minneapolis, Minnesota, United States
- Naljayan, Mihran V., DaVita Inc, Denver, Colorado, United States
Background
Nontuberculous mycobacterium (NTM) infections in peritoneal dialysis (PD) can lead to morbidity, including hospitalization and catheter removal. Our aim was to describe demographics and outcomes associated with NTM infections among a population of PD patients.
Methods
The study population comprised PD patients with at least one positive exit site or PD fluid culture collected between 1/1/19 and 12/31/23. Data included lab results, demographics, and hospital admission and dialysis treatment dates obtained from electronic medical records at a large dialysis provider (average 26,000 PD patients treated annually). Infection events were defined by positive cultures. Cultures resulting in any NTM organism were categorized as NTM infection events, and cultures resulting in non-NTM organism(s) were categorized as “other.” Outcomes were hospital admission and discontinuation of PD within 30 days of culture collection date.
Results
Over the 5-year period, NTM (N=305) showed greater tropism for exit site (vs PD fluid) than other organisms (79% vs 44% infections at exit site). Regarding demographics among patients with NTM infection, median age at infection was 60 years; 62% were male and 46%, 24%, and 18% were non-Hispanic White, Hispanic, and non-Hispanic Black, respectively. At the time cultures were collected, median time on PD was 5 months (IQR: 2-13). The majority of cases occurred in the Southeast (49%) or Southwest (21%) regions of the US. Thirty-day risks for hospital admission and discontinuation of PD were greater following NTM infection events (35%, 28%, respectively) than following non-NTM infections (21%, 7%, respectively): adjusted odds ratio (aOR) 3.1, 95% CI: 2.8-3.3 for hospital admission and aOR 8.3, 95% CI: 8.0-8.6 for PD discontinuation. Exit site infection-specific risks for outcomes were also greater for NTM infections (aOR 2.0, 95% CI: 1.7-2.3 for hospital admission and aOR 7.9, 95% CI: 7.5-8.2 for PD discontinuation).
Conclusion
NTM infections among PD patients most commonly occurred among patients treating in the southern US and as exit site infections rather than PD fluid infections. Even after controlling for culture source and demographic factors, NTM infection events were associated with more frequent negative outcomes, including hospitalization and discontinuation of PD, compared with other infections.