Bacterial pathogens in peritoneal dialysis peritonitis: Insights from next-generation sequencing

Background: Peritoneal dialysis (PD) peritonitis is a feared complication of PD, with significant sequelae for the patient. The cause of PD peritonitis is largely due to a single organism (≥75% of cases) and rarely due to multiple organisms. Methods: In this pilot study, we investigated 25 cases of...

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Bibliographic Details
Published in:Peritoneal dialysis international 2020-11, Vol.40 (6), p.581-586
Main Authors: van Hougenhouck-Tulleken, Wesley G, Lebre, Pedro H, Said, Mohamed, Cowan, Don A
Format: Article
Language:English
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Summary:Background: Peritoneal dialysis (PD) peritonitis is a feared complication of PD, with significant sequelae for the patient. The cause of PD peritonitis is largely due to a single organism (≥75% of cases) and rarely due to multiple organisms. Methods: In this pilot study, we investigated 25 cases of PD peritonitis with 16S ribosomal RNA (rRNA) next-generation sequencing (NGS) techniques. Results: Total concordance between culture and NGS was noted. In addition, the NGS technique was highly sensitive, identifying 33 different bacteria (including a nonculturable bacterium), compared to 13 bacterial species using culture-based techniques. This was counterbalanced by a lack of specificity with NGS, largely due to the small size of the 16S rRNA gene segment sequenced. Conclusions: For the clinician, our results suggest that PD peritonitis may often be a polymicrobial disease and that treating a dominant organism may not totally eradicate all bacterial contamination within the peritoneum. For the clinical scientist, additional use of a larger 16S rRNA segment (V5 or V6) is likely to outperform the use of the V4 segment only.
ISSN:0896-8608
1718-4304
DOI:10.1177/0896860820908473