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Atypical mycobacterial exit-site infection and peritonitis in peritoneal dialysis patients on prophylactic exit-site

Man-wai Lo1, Siu-ka Mak, Yuk-yi Wong

  • 1Renal Unit, Department of Medicine and Geriatrics, and Microbiology Unit,1 Department of Pathology, Kwong Wah Hospital, Hong Kong SAR, PR China. lomw@hgcbroadband.com

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|October 4, 2012
PubMed

Insights

Topical gentamicin cream prophylaxis may increase the risk of atypical mycobacterial infections in patients undergoing continuous ambulatory peritoneal dialysis. This study discusses the microbiology and treatment of these infections.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Microbiology

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) is a common treatment for end-stage renal disease.
  • Exit-site infections and peritonitis are significant complications of CAPD.
  • Atypical mycobacteria are increasingly recognized as opportunistic pathogens.

Observation:

  • Nine cases of exit-site infection and CAPD peritonitis caused by atypical mycobacteria were identified.
  • All affected patients had previously used topical gentamicin cream for exit-site infection prophylaxis.
  • The use of gentamicin cream preceded the onset of atypical mycobacterial infections.

Findings:

  • Topical gentamicin cream may act as a selective pressure, favoring the overgrowth of atypical mycobacteria.
  • This selective pressure could contribute to the development of both exit-site infections and peritonitis.
  • Atypical mycobacterial infections present a unique challenge in CAPD patients.

Implications:

  • Healthcare providers should consider the potential role of topical antibiotics in the emergence of atypical mycobacterial infections.
  • Alternative prophylactic strategies for exit-site infections in CAPD patients may be warranted.
  • Further research into the microbiology and optimal treatment of atypical mycobacterial infections in CAPD is crucial.
Keywords:
Atypical mycobacterial infectionexit siteperitonitis

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