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Vancomycin-resistant peritonitis associated with peritoneal dialysis: a cause for concern

A O'Riordan1, K A Abraham, J Kee Ho

  • 1Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.

Irish Journal of Medical Science
|May 8, 2002
PubMed
Abstract

Insights

Peritonitis in peritoneal dialysis (PD) patients is a serious risk. Antibiotic resistance, particularly to vancomycin, is a growing concern, necessitating careful antibiotic selection and monitoring to combat "super bugs".

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Peritonitis is a significant complication in patients undergoing peritoneal dialysis (PD).
  • Recurrent antibiotic exposure in PD patients increases the risk of developing antibiotic resistance.
  • Vancomycin resistance in peritonitis poses a therapeutic challenge.

Observation:

  • Two cases of vancomycin-resistant peritonitis in PD patients are presented.
  • These cases highlight the emergence of multi-drug resistant organisms in this vulnerable population.
  • The patients had a history of multiple antibiotic courses.

Findings:

  • Peritonitis in PD patients can become resistant to standard antibiotic treatments like vancomycin.
  • Multi-drug resistance is an increasing threat in dialysis-associated infections.
  • Failure to control infections may necessitate catheter removal.

Implications:

  • Judicious antibiotic use and appropriate dosing are crucial in PD patients.
  • Regular monitoring of microbial sensitivity patterns is essential to guide treatment.
  • Vigilance is required to prevent the development of extensively drug-resistant organisms.
  • Early removal of PD catheters may be necessary for persistent infections.

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