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Xanthomonas maltophilia infection in chronic peritoneal dialysis patients
N Al-Hilali1, M R Nampoory, K V Johny
1Department of Medicine and Microbiology, Mubarak Al-Kabeer Hospital, Kuwait.
Abstract:
Xanthomonas maltophilia infection has only been occasionally reported in patients receiving chronic peritoneal dialysis. We describe four cases of Xanthomonas maltophilia infection associated with chronic peritoneal dialysis. Two patients presented with peritonitis and two with exit site infection. All patients were diabetics, who immediately prior to the study had not received antibiotic therapy. Failure to respond to multiple antibiotic therapy resulted in catheter removal in both patients with peritonitis. In those patients with only exit site infections, dialysis could be continued following antibiotic therapy and catheter replacement in one. Catheter loss in our patients was directly attributed to peritonitis with Xanthomonas maltophilia infection.
Insights
Xanthomonas maltophilia infections are rare in chronic peritoneal dialysis patients. This study highlights four cases, showing catheter loss due to peritonitis, emphasizing the need for prompt management in diabetic patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Microbiology
Background:
- Xanthomonas maltophilia infections are infrequently documented in patients undergoing chronic peritoneal dialysis.
- This study focuses on the clinical presentation and management of such infections.
Purpose of the Study:
- To describe four cases of Xanthomonas maltophilia infection in patients on chronic peritoneal dialysis.
- To analyze the outcomes of treatment and the impact on dialysis management.
Main Methods:
- Case series describing four patients with Xanthomonas maltophilia infection.
- Review of clinical presentations (peritonitis, exit site infection) and treatment responses.
- Analysis of factors leading to catheter removal or replacement.
Main Results:
- Two patients developed peritonitis, and two had exit site infections.
- All affected patients had diabetes mellitus and had not recently received antibiotics.
- Peritonitis cases required catheter removal due to non-response to multiple antibiotics.
- One exit site infection case allowed continued dialysis after antibiotic therapy and catheter replacement.
Conclusions:
- Xanthomonas maltophilia peritonitis in peritoneal dialysis patients often necessitates catheter removal.
- Exit site infections may be manageable with antibiotics and catheter replacement, allowing dialysis continuation.
- Catheter loss is a significant risk associated with Xanthomonas maltophilia peritonitis in this population.