Questions About PD
You will find the answers in the ISPD guideline to peritonitis prevention and treatment 2016http://www.pdiconnect.com/content/36/5/481/T7.expansion.html
The definitions of recurrent, relapsing and repeat peritonitis are below:
Recurrent: An episode that occurs within 4 weeks of completion of therapy of a prior episode but with a different organism
Relapsing: An episode that occurs within 4 weeks of completion of therapy of a prior episode with the same organism or a sterile episode
Repeat: An episode that occurs more than 4 weeks after completion of therapy of a prior episode with the same organism
Since this was a sterile episode occurring less than 4 weeks after completion of antibiotics for the Proteus peritonitis, it would be considered a relapsing episode.
With regard to culture negative peritonitis, these should ideally represent <15% of all peritonitis episodes in any PD unit. The optimal culture technique is described in detail in the 2016 ISPD peritonitis recommendations: “Bedside inoculation of 5-10 ml effluent in 2 (aerobic and anaerobic) blood-culture bottles has a reasonable sensitivity, and the culture-negative rate is typically around 10-20%. (210,211). The yield of peritoneal fluid culture is enhanced by inoculating the fluid directly into rapid blood-culture bottle kits, centrifuging PD fluid and culturing the pellet, or the lysis centrifugation technique compared to inoculation into standard blood-culture bottles. Specifically, centrifugation of 50 mL PD effluent at 3,000 g for 15 minutes, followed by resuspension of the sediment in 3-5 mL supernatant and inoculation on solid culture media or standard blood-culture media, increases the yield by 5 to 10 times but is more cumbersome.”