The microbiological epidemiology of infections in peritoneal dialysis over a 45-year period in the Peritoneal Dialysis Registry in France (RDPLF)

• Published in: Bulletin de la dyalise à domicile Vol. 8; no. 3; pp. 229 - 240
• Main Authors: Florian Baquer, Françoise Heibel, Larbi Bencheikh, Antoine Grillon
• Format: Journal Article
• Language: English
• Published: RDPLF 01.09.2025
• Subjects: dialyse péritonéale; infection; microbiologie; péritonite
• ISSN: 2607-9917
• DOI: 10.25796/bdd.v8i3.87082

Infectious peritonitis remains a frequent complication of peritoneal dialysis. Over the years, numerous technical advancements have been introduced, aimed at both reducing the incidence of these infections and enhancing their microbiological characterization. In this study, we analyzed 26,235 peritonitis episodes recorded in the French-Language Peritoneal Dialysis Registry (RDPLF) database to describe the evolution of infectious epidemiology from the 1980s to the present day. Our findings reveal a marked decrease in the proportion of staphylococcal infections between 1978 and 2010. Conversely, infections caused by Enterobacteriaceae, enterococci, and streptococci have progressively increased over the same period. The modality of peritoneal dialysis appears to be associated with specific bacterial profiles: infections involving skin flora are more prevalent in continuous ambulatory peritoneal dialysis, whereas those of environmental or mixed (oral/gastrointestinal) origin are more frequently observed with automated peritoneal dialysis. The advent of advanced diagnostic techniques, particularly molecular biology methods, has significantly improved the microbiological documentation of peritonitis, especially for organisms that are non-cultivable or difficult to culture by conventional laboratory methods. In summary, this study presents the microbiological trends observed in peritoneal dialysis-associated peritonitis in France from the 1980s to the present, based on data from over 20,000 patients included in the RDPLF database, and highlights the impact of evolving technological approaches on the detection and understanding of these infections.