Xanthomonas maltophilia peritonitis in uremic patients receiving continuous ambulatory peritoneal dialysis

Am J Kidney Dis. 1997 Jan;29(1):91-5. doi: 10.1016/s0272-6386(97)90013-5.

Abstract

Xanthomonas maltophilia peritonitis has been only occasionally reported in patients receiving continuous ambulatory peritoneal dialysis. We present a series of six cases of peritonitis caused by such bacteria, accounting for 1.5% of all peritonitis episodes encountered in our renal unit over the past 5 years. Recent bacterial peritonitis treated with broad-spectrum antibiotics was the major risk factor, and the outcome was poor with medical treatment alone. Secondary peritonitis, especially fungal, was common and probably related to the prolonged course of antibiotics. All patients eventually required removal of the catheter, either because the effluent failed to clear up or because of secondary peritonitis. We suggest that X maltophilia peritonitis be treated with double antibiotics as soon as it is diagnosed. To prevent the development of superimposed infection after prolonged administration of antibiotics, the Tenckhoff catheter should be removed if the peritonitis fails to respond to a short course of antibiotics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents
  • Cross Infection / diagnosis*
  • Cross Infection / drug therapy
  • Cross Infection / etiology
  • Drug Therapy, Combination / pharmacology
  • Drug Therapy, Combination / therapeutic use
  • Female
  • Gram-Negative Bacterial Infections / diagnosis*
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / etiology
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mycoses / diagnosis
  • Mycoses / etiology
  • Peritoneal Dialysis, Continuous Ambulatory* / instrumentation
  • Peritonitis / diagnosis*
  • Peritonitis / drug therapy
  • Peritonitis / etiology
  • Time Factors
  • Uremia / complications
  • Uremia / therapy*
  • Xanthomonas* / drug effects
  • Xanthomonas* / isolation & purification

Substances

  • Anti-Bacterial Agents