Acinetobacter peritonitis in patients receiving continuous ambulatory peritoneal dialysis

Area of Science:

• Nephrology
• Infectious Diseases
• Microbiology

Background:

• Peritonitis is a serious complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
• Acinetobacter species peritonitis in CAPD patients is infrequently documented.
• Limited data exists on the effective management of Acinetobacter peritonitis in CAPD.

Purpose of the Study:

• To investigate the clinical manifestations, treatment, and outcomes of Acinetobacter peritonitis in CAPD patients.
• To evaluate the efficacy of antimicrobial therapy in eradicating Acinetobacter peritonitis.
• To compare Acinetobacter peritonitis outcomes with other common CAPD peritonitis pathogens.

Main Methods:

• Retrospective review of medical records, dialysis unit charts, and microbiology logs.
• Identification of 18 patients with Acinetobacter peritonitis undergoing CAPD.
• Analysis of clinical presentations, treatment regimens, and patient outcomes.

Main Results:

• All 18 cases were community-acquired with no identified epidemiological links.
• Common symptoms included abdominal pain/tenderness (13 patients) and cloudy dialysate (6 patients); fever was rare (2 patients).
• Intraperitoneal aminoglycoside therapy (mean 10.7 days) was successful in 14 cases; other antibiotics (gentamicin/ciprofloxacin, ceftriaxone) were also effective. Tenckhoff catheter removal was required in only one patient.

Conclusions:

• Acinetobacter peritonitis in CAPD patients is generally responsive to antimicrobial therapy alone.
• Treatment with intraperitoneal antibiotics is effective and often avoids the need for catheter removal.
• Unlike other CAPD peritonitis pathogens, Acinetobacter infections demonstrate good susceptibility to standard antimicrobial regimens.