scholarly journals Aeromonas Sobria: a Rare Cause of Continuous Ambulatory Peritoneal Dialysis-Related Peritonitis

2017 ◽  
Vol 24 (2) ◽  
Author(s):  
Andreja Figurek ◽  
Vlastimir Vlatkovic ◽  
Dragan Vojvodic
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Pseudomembranous Colitis ◽  
Normal Skin ◽  
Aeromonas Species ◽  
Gram Negative Bacteria ◽  
Aeromonas Sobria ◽  
Skin Flora ◽  
Common Causes ◽  
Gram Positive Cocci

Peritonitis is a very common complication in patients treated with continuous ambulatory peritoneal dialysis. The most common causes are gram positive cocci (part of the normal skin flora), and then gram negative bacteria, while fungi are listed as a rare cause of peritonitis. Aeromonas species are identified as a rare cause of continuous ambulatory peritoneal dialysis-related peritonitis. Among them, Aeromonas hydrophila is somewhat more common, followed by Aeromonas caviae.Case presentation. We reported a case of continuous ambulatory peritoneal dialysis peritonitis caused by Aeromonas sobria that is extremely rare cause of this type of peritonitis. In our patient, pseudomembranous colitis occured as a complication and, reinfection – another episode of peritonitis with Klebsiella pneumoniae. Treatment with third-episode cephalosporins was successful and patient continued treatment with continuous ambulatory peritoneal dialysis. Conclusions. The rare causes of peritonitis should not be ignored, especially those which lead to increased morbidity and mortality of patients.

scholarly journals Prevalence of peritonitis-associated coagulase-negative staphylococci on the skin of continuous ambulatory peritoneal dialysis patients

1989 ◽  
Vol 102 (3) ◽  
pp. 365-378 ◽  
Author(s):  
M. A. Beard-Pegler ◽  
C. L. Gabelish ◽  
E. Stubbs ◽  
C. Harbour ◽  
J. Robson ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Profile Analysis ◽  
Normal Skin ◽  
Plasmid Profile ◽  
Phage Typing ◽  
Body Site ◽  
Dialysis Fluid ◽  
Coagulase Negative Staphylococci ◽  
Skin Flora

SUMMARYThe predominance of coagulase-negative staphylococci as normal skin flora is thought to be a factor in their association with episodes of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. We investigated the prevalence of peritonitis-associated strains on the skin of 28 patients undergoing peritoneal dialysis. Coagulase-negative staphylococci were the most frequently isolated organisms. comprising 47% of peritoncal dialysis fluid isolates and 59% of body site isolates. A total of 142 coagulase-negative staphylococci were speciated. tested for their antimicrobial sensitivity and slime production. and identified by phage typing and plasmid-profile analysis.Staphylococcus epidermidiswas the most commonly identified species from both peritoncal dialysis fluid (73%) and body sites (53%). Multiple antibiotic resistance was common, and the greater proportion of isolates were resistant to methicillin: 63·6% of peritoncal dialysis fluid isolates and 61·7% of body-site isolates.isolates.S. haemolyticusisolates were significantly more resistant to methicillin than other species. By phage typing and plasmid-profile analysis it was shown that peritonitis was rarely caused by skincolonizing strains. In only 3 of 14 patients were peritonitis-associated strains isolated as skin colonizers, and no patients developed peritonitis due to organisms previously isolated as skin colonizers.

Plasmid Profile and Slime Analysis of Coagulase-Negative Staphylococci from Capd Patients with Peritonitis

1986 ◽  
Vol 6 (4) ◽  
pp. 195-198 ◽  
Author(s):  
Gregory B. Horsman ◽  
Leslie MacMillan Yuri ◽  
Amatnieks Oretta RifKin ◽  
Stephen I. Vas
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Normal Skin ◽  
Recurrent Infection ◽  
Plasmid Profile ◽  
Coagulase Negative Staphylococci ◽  
Plasmid Profiles ◽  
Skin Flora ◽  
Initial Episode ◽  
Multiple Episodes

Little is known about the epidemiology of infections causing peritonitis in continuous ambulatory peritoneal dialysis (CAPD). The commonest cause, coagulase-negative staphylococci (C-NS), are normal skin flora. The main source is thought to be organisms from the patient's own skin or environment. Using plasmid profiles as an epidemiological marker, the authors identified cases in which surveillance skin cultures taken just before an episode of peritonitis were identical to those isolated from the effluent. On comparing the plasmid profiles from the effluent of patients who had multiple episodes over eight weeks, they identified two patterns. One group had different plasmid profiles between episodes of infection. The second group (the majority of the cases) had identical plasmid profiles between the initial episode and the second which occurred between 10 days and four weeks after stopping antibiotics. This suggests that, in most cases of recurrent infection studied, the second episode represented a reinfection or recurrence with the same organism (as the initial episode). Slime production did not discriminate those patients who would develop recurring peritonitis.

Newer Quinolones in the Treatment of Continuous Ambulatory Peritoneal Dialysis (CAPD) Related Infections

1990 ◽  
Vol 10 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Paul Nikolaidis
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Adverse Reactions ◽  
Antimicrobial Agents ◽  
Hospital Staff ◽  
Gram Negative Bacteria ◽  
Promising Alternative ◽  
Gram Negative ◽  
Dosing Intervals ◽  
Good Oral Bioavailability

Newer fluoroquinolones such as ciprofloxacin, pefloxacin, ofloxacin, enoxacin, and fleroxacin are potent antimicrobial agents against many gram-negative bacteria, including Pseudomonas aeruginosa species and staphylococci-sensitive or resistant to methicillin. They are almost completely absorbed when given orally, reaching therapeutic plasma and dialysate concentrations, and their long half lives permit infrequent dosing intervals. Clinical studies on fluoroquinolones efficacy in continuous ambulatory peritoneal dialysis (CAPD) infections, although not extensive, demonstrate good results. They are well tolerated and the adverse reactions, consisting mainly of gastrointestinal disturbance, were uncommon, mild, and reversible. The fluoroquinolones offer a promising alternative to standard parenteral treatments in CAPD patients, while their good oral bioavailability makes them attractive and convenient for both patients and hospital staff. However, they must be used with caution until we have more information and gain further experience.

scholarly journals Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis.

1992 ◽  
Vol 5 (1) ◽  
pp. 36-48 ◽  
Author(s):  
A von Graevenitz ◽  
D Amsterdam
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Antimicrobial Agents ◽  
Positive Culture ◽  
Bloodstream Infections ◽  
Peritoneal Macrophages ◽  
Gram Stain ◽  
Coagulase Negative Staphylococci ◽  
Safe Alternative ◽  
Skin Flora

The process of continuous ambulatory peritoneal dialysis has provided a useful, relatively inexpensive, and safe alternative for patients with end-stage renal disease. Infectious peritonitis, however, has limited a more widespread acceptance of this technique. The definition of peritonitis in this patient population is not universally accepted and does not always include the laboratory support of a positive culture (or Gram stain). In part, the omission of clinical microbiological findings stems from the lack of sensitivity of earlier microbiological efforts. Peritonitis results from decreased host phagocytic efficiency with depressed phagocytosis and bactericidal capacity of peritoneal macrophages. During episodes of peritonitis, fluid movement is reversed, away from the lymphatics and peritoneal membrane and toward the cavity. As a result, bloodstream infections are rare. Most peritonitis episodes are caused by bacteria. Coagulase-negative staphylococci are the most frequently isolated organisms, usually originating from the skin flora, but a wide array of microbial species have been documented as agents of peritonitis. Clinical microbiology laboratories need to be cognizant of the diverse agents so that appropriate primary media can be used. The quantity of dialysate fluid that is prepared for culture is critical and should constitute at least 10 ml. The sensitivity of the cultural approach depends on the volume of dialysate, its pretreatment (lysis or centrifugation), the media used, and the mode of incubation. The low concentration of microorganisms in dialysate fluids accounts for negative Gram stain results. Prevention of infection in continuous ambulatory peritoneal dialysis patients is associated with the socioeconomic status of the patient, advances in equipment (catheter) technology, and, probably least important, the application of prophylactic antimicrobial agents.

Campylobacter Peritonitis Complicating Continuous Ambulatory Peritoneal Dialysis: Report of Three Cases and Review of the Literature

2010 ◽  
Vol 30 (1) ◽  
pp. 99-104 ◽  
Author(s):  
Sittana S. Elshafie ◽  
Muhammad Asim ◽  
Adel Ashour ◽  
Abdul Haleem Elhiday ◽  
Thoraya Mohsen ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Molecular Techniques ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Culture Techniques ◽  
Oxidase Test ◽  
Campylobacter Species ◽  
Micro Organisms ◽  
Better Than

BackgroundThe micro-organisms involved in continuous ambulatory peritoneal dialysis (CAPD) peritonitis are usually gram-positive cocci of cutaneous origin. Campylobacter species are rarely implicated as a cause of CAPD peritonitis.MethodsA retrospective review of 100 consecutive episodes of peritonitis was carried out in patients undergoing CAPD or automated PD in our hospital from June 2004 to December 2007. Collection of dialysate and microbial examination was done according to ISPD guidelines. Identification of the organism was made on the basis of Gram smear morphology, positive oxidase test, and biochemical reactions using API Campi (BioMérieux, Marcy l'Étoile, France). Susceptibility testing was performed using E-test (AB Biodisc, Solna, Sweden) and confirmation was done by molecular techniques.ResultsThe causative organisms in 23 of these episodes were gram-negative bacteria, 3 of which were identified as Campylobacter species using special culture techniques. The clinical presentation in our patients with Campylobacter peritonitis (CP) was different from that of patients with peritonitis from other organisms in that all 3 had diarrhea at presentation. Among patients with CP, no subspecies-specific feature was identified. Good response to the antibiotic treatment was observed; there was no relapse/recurrence of peritonitis, catheter loss, or death.ConclusionIncidence of CP remains low and, regardless of the subtype, clinical outcomes are better than those seen with other gram-negative bacteria such as Pseudomonas. The presence of diarrhea at presentation and the finding of curved or spiral gram-negative bacilli in the Gram smear of peritoneal dialysis effluent should make one think of CP. The use of appropriate microbiology techniques in this situation will increase the isolation of this organism.

scholarly journals Peritonitis Due to Roseomonas fauriae in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis

2000 ◽  
Vol 38 (1) ◽  
pp. 456-457
Author(s):  
Evangelia Bibashi ◽  
Danai Sofianou ◽  
Konstantina Kontopoulou ◽  
Efstathios Mitsopoulos ◽  
Elisabeth Kokolina
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Clinical Specimens ◽  
Human Infections

ABSTRACT Roseomonas is a newly described genus of pink-pigmented, nonfermentative, gram-negative bacteria that have been recognized as a cause of human infections. Roseomonas fauriae is a species rarely isolated from clinical specimens. We report the first known case of peritonitis caused by R. fauriae in a patient receiving continuous ambulatory peritoneal dialysis.

scholarly journals Lercanidipin chylous peritonitis

2018 ◽  
Vol 1 (1) ◽  
pp. 43-46
Author(s):  
Hanene Gaied ◽  
Maan Joseph
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Chronic Renal Failure ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Rare Complication ◽  
Drainage Fluid ◽  
Common Causes

We report a case of lercanidipin-induced chylous peritonitis (CP) occurring in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD), a 22-year-old male with chronic renal failure with indeterminate nephropathy.. The patient presented a turbid drainage fluid at the start of peritoneal dialysis (PD). The chyloperitoneum resolved after stopping lercanidipin without recurrence.Lercanidipin induced-chyloperitoneum is a rare complication in PD. It is a benign form of non-infectious peritonitis that can be confused with an infectious peritonitis. The most common causes of CP are infectious, obstructive and abdominal malignancy.This paper discusses the possible causes of CP, the physiopathology and the management of lercanidipin-induced chyloperitoneum.

Scanning Electron Microscopy of Staphylococcus Epidermidis Adherence to Continuous Ambulatory Peritoneal Dialysis Catheters

1985 ◽  
Vol 43 ◽  
pp. 520-521
Author(s):  
William J. Lamoreaux ◽  
David L. Smalley ◽  
Larry M. Baddour ◽  
Alfred P. Kraus
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Staphylococcus Epidermidis ◽  
Sterile Saline ◽  
Intravascular Devices ◽  
Capd Patient ◽  
Scanning Electron

Infections associated with the use of intravascular devices have been documented and have been reported to be related to duration of catheter usage. Recently, Eaton et al. reported that Staphylococcus epidermidis may attach to silastic catheters used in continuous ambulatory peritoneal dialysis (CAPD) treatment. The following study presents findings using scanning electron microscopy (SEM) of S. epidermidis adherence to silastic catheters in an in vitro model. In addition, sections of polyvinyl chloride (PVC) dialysis bags were also evaluated by SEM.The S. epidermidis strain RP62A which had been obtained in a previous outbreak of coagulase-negative staphylococcal sepsis at local hospitals was used in these experiments. The strain produced surface slime on exposure to glucose, whereas a nonadherent variant RP62A-NA, which was also used in these studies, failed to produce slime. Strains were grown overnight on blood agar plates at 37°C, harvested from the surface and resuspended in sterile saline (0.85%), centrifuged (3,000 rpm for 10 minutes) and then washed twice in 0.1 M phosphate-buffered saline at pH 7.0. Organisms were resuspended at a concentration of ca. 106 CFU/ml in: a) sterile unused dianeal at 4.25% dextrose, b) sterile unused dianeal at 1.5% dextrose, c) sterile used dialysate previously containing 4.25% dextrose taken from a CAPD patient, and d) sterile used dialysate previously containing 1.5% dextrose taken from a CAPD patient.

Case Report. Candida lusitaniae peritonitis in a patient on continuous ambulatory peritoneal dialysis

Mycoses ◽  
2002 ◽  
Vol 45 (3-4) ◽  
pp. 120-122 ◽  
Author(s):  
S. Cinar ◽  
A. Nedret Koc ◽  
H. Taskapan ◽  
A. Dogukan ◽  
B. Tokgoz ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Candida Lusitaniae
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