Standardized Peritonitis Reporting: A Quality Improvement Initiative of the Optimizing Prevention of Peritoneal Dialysis–Associated Peritonitis in the United States (OPPUS) Study

Peritoneal dialysis (PD)-associated peritonitis (peritonitis) is an important outcome to patients, caregivers, and kidney health professionals in the multinational Standardized Outcomes in Nephrology (SONG) PD initiative ( 1 Manera K.E. Johnson D.W. Craig J.C. Shen J.I. Ruiz L. Wang A.Y. et al. Patient and Caregiver Priorities for Outcomes in Peritoneal Dialysis: Multinational Nominal Group Technique Study. Clinical journal of the American Society of Nephrology : CJASN. 2019; 14: 74-83https://doi.org/10.2215/cjn.05380518 Crossref PubMed Scopus (0) Google Scholar ). Peritonitis carries substantial morbidity and is a leading cause of premature transition to in-center hemodialysis (ICHD) ( 2 Al Sahlawi M. Zhao J. McCullough K. Fuller D.S. Boudville N. Ito Y. et al. Variation in Peritoneal Dialysis-Related Peritonitis Outcomes in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS). American journal of kidney diseases : the official journal of the National Kidney Foundation. 2022; 79: 45-55.e1https://doi.org/10.1053/j.ajkd.2021.03.022 Abstract Full Text Full Text PDF Scopus (23) Google Scholar , 3 Mujais S. Microbiology and outcomes of peritonitis in North America. Kidney international Supplement. 2006; : S55-62https://doi.org/10.1038/sj.ki.5001916 Abstract Full Text Full Text PDF Scopus (100) Google Scholar , 4 Ghali J.R. Bannister K.M. Brown F.G. Rosman J.B. Wiggins K.J. Johnson D.W. et al. Microbiology and outcomes of peritonitis in Australian peritoneal dialysis patients. Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. 2011; 31: 651-662https://doi.org/10.3747/pdi.2010.00131 Crossref PubMed Scopus (159) Google Scholar ). In the end-stage renal disease (ESRD) quality incentive program, the Centers for Medicare & Medicaid Services (CMS) incorporated bloodstream infections (BSIs) in ICHD patients as a quality measure in 2012, with data being reported to Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) surveillance system. This has led to reduced infection rates among ICHD patients ( 5 Patel P.R. Yi S.H. Booth S. Bren V. Downham G. Hess S. et al. Bloodstream infection rates in outpatient hemodialysis facilities participating in a collaborative prevention effort: a quality improvement report. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2013; 62: 322-330https://doi.org/10.1053/j.ajkd.2013.03.011 Abstract Full Text Full Text PDF PubMed Scopus (88) Google Scholar , 6 Yi S.H. Kallen A.J. Hess S. Bren V.R. Lincoln M.E. Downham G. et al. Sustained Infection Reduction in Outpatient Hemodialysis Centers Participating in a Collaborative Bloodstream Infection Prevention Effort. Infect Control Hosp Epidemiol. 2016; 37: 863-866https://doi.org/10.1017/ice.2016.22 Crossref PubMed Scopus (22) Google Scholar ). In PD patients, a formal surveillance system for nationwide reporting of PD-related peritonitis is needed. Here, we developed a uniform widescale peritonitis reporting mechanism based on current International Society for Peritoneal Dialysis (ISPD) peritonitis guidelines to evaluate its implementation in The Optimizing Prevention of PD-Associated Peritonitis in the US (OPPUS) study facilities as a test of the feasibility of standardized peritonitis reporting.