ETIOLOGICAL CHARACTERIZATION AND ASSOCIATION OF HOST GENETIC FACTOR IN PERITONEAL DIALYSIS PATIENTS WITH PERITONITIS

Abstract

Peritoneal dialysis (PD) is an established modality of treatment for patients with end stage renal disease (ESRD). Peritonitis is a leading cause of technique failure and death in patients on PD. Reduction of the time required to identify the bacteria is highly desirable for rapid clinical diagnosis which leads to prompt initiation of antibiotic regimen in PD patients with peritonitis. Several exogenous factors have been implicated in the development of peritonitis and associated complications including cardiac events, but the role of host factors are least studied. In recent years, Toll-like receptors (TLRs), cytokines and cell adhesion molecules (CAMs) are believed to be implicated in the pathogenesis of several autoimmune and inflammatory diseases. Therefore, present study was planned to explore a better etiologic diagnostic approach and immunopathogenesis of peritonitis in PD patients. The summary of the study are as follows: 16S rRNA gene based universal PCR with an additional step of Gram type-specific PCR and then sequencing helps in rapid preliminary classification of bacteria in to Gram positive or Gram negative bacteria or mixed infection (both Gram positive and Gram negative bacteria). This will allow the early choice of antibiotic treatment targeted to either Gram positive or Gram negative or to both types of bacterial species. Moreover, it is also useful in the identification of newer species, which are fastidious and non-cultivable.It can form the basis for the development of a rapid and sensitive procedure for the etiological diagnosis of peritonitis caused by fastidious and non-cultivable microbes. Furthermore, conventional microbiological methods would still be required for determination of the antibiotic susceptibility of bacteria isolated from clinical samples of peritonitis patient. newline