Peritoneal dialysis peritonitis by anaerobic pathogens: a retrospective case series

BMC Nephrology

Jenq-Wen Huang⁵  Kuan-Yu Hung⁵  Chih-Kang Chiang⁶  Chung-Jen Yen²  Cheng-Chung Fang³  Huei-Wen Chen⁵  Wei-Shun Yang¹  Szu-Ying Lee⁴  Chia-Ter Chao⁵ 

[1] Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu County, Taiwan;Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan;Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan;Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan;Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan;Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, 100, Taiwan

关键词: Peritonitis;    Peritoneal dialysis;    End-stage renal disease;    Anaerobics;   

Others  :  1082928
DOI  :  10.1186/1471-2369-14-111

 received in 2013-02-21, accepted in 2013-05-20,  发布年份 2013

【 摘 要 】

Background

Bacterial infections account for most peritoneal dialysis (PD)-associated peritonitis episodes. However, anaerobic PD peritonitis is extremely rare and intuitively associated with intra-abdominal lesions. In this study, we examined the clinical characteristics of PD patients who developed anaerobic peritonitis.

Methods

We retrospectively identified all anaerobic PD peritonitis episodes from a prospectively collected PD registry at a single center between 1990 and 2010. Only patients receiving more than 3 months of PD were enrolled. We analyzed clinical features as well as outcomes of anaerobic PD peritonitis patients.

Results

Among 6 patients, 10 episodes of PD-associated peritonitis were caused by anaerobic pathogens (1.59% of all peritonitis episodes during study the period), in which the cultures from 5 episodes had mixed growth. Bacteroides fragilis was the most common species identified (4 isolates). Only 3 episodes were associated with gastrointestinal lesions, and 4 episodes were related to a break in sterility during exchange procedures. All anaerobic pathogens were susceptible to clindamycin and metronidazole, but penicillin resistance was noted in 4 isolates. Ampicillin/sulbactam resistance was found in 2 isolates. In 5 episodes, a primary response was achieved using the first-generation cephalosporin and ceftazidime or aminoglycoside. In 3 episodes, the first-generation cephalosporin was replaced with aminoglycosides. Tenckhoff catheter removal was necessary in 2 episodes. Only one episode ended with mortality (due to a perforated bowel).

Conclusion

Anaerobic PD-associated peritonitis might be predominantly caused by contamination, rather than intra-abdominal events. Half of anaerobic PD-associated peritonitis episodes had polymicrobial growth. The overall outcome of anaerobic peritonitis is fair, with a high catheter survival rate.

【 授权许可】

   
2013 Chao et al.; licensee BioMed Central Ltd.

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