Apart from Escherichia coli, the other most common organism implicated in acute suppurative bacterial peritonitis is-

• When bacteria contaminate the peritoneum as a result of spillage from an intra-abdominal viscus. • Infection in secondary bacterial peritonitis is polymicrobial • E. coli and Bacteroides are MC organisms. • The species of organism isolated vary with the source of the initial process and the normal flora present at the site. • Peritonitis is one of the MC complications of CAPDQ, occurring with an incidence of approximately one episode every 1 to 3 years. • Refractory or recurrent peritonitis is MC cause of technical failure of CAPD. • MC organism: Staphylococcus epidermidis (30–50%). Clinical Features • Patients present with abdominal pain, fever, and cloudy peritoneal dialysate containing >100 WBC/mm3, with >50% of the cells being neutrophils. • Gram staining detects organisms only in 10–40% of cases. Treatment • CAPD associated peritonitis is treated by the intraperitoneal administration of antibiotics, usually a first-generation cephalosporin. • Overall, 75% of infections are cured by culture-directed antibiotic therapy. • Recurrent or persistent peritonitis requires removal of the dialysis catheter and resumption of hemodialysis.