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Extended spectrum beta lactamase peritonitis: Time for innovation?
Indian Journal of Nephrology
|January 18, 2013
Summary
Extended spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae caused peritonitis in a child on dialysis. Intravenous meropenem and oral cotrimoxazole successfully treated this serious infection.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pediatrics
Background:
- Extended spectrum beta-lactamase (ESBL) producing bacteria pose a significant threat due to their resistance to common antibiotics, including cephalosporins.
- Peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) is a serious complication that requires effective antimicrobial therapy.
Observation:
- A seven-year-old child on CAPD developed peritonitis caused by ESBL-producing Klebsiella pneumoniae.
- The causative bacterium exhibited resistance to standard intraperitoneal antibiotics typically used for peritonitis.
Findings:
- Successful treatment was achieved using intravenous meropenem combined with oral cotrimoxazole.
- This treatment regimen effectively addressed the multidrug-resistant bacterial infection.
Implications:
- The case underscores the growing challenge of ESBL-producing bacterial infections, particularly peritonitis, in immunocompromised patients.
- There is an urgent need for updated clinical guidelines to manage ESBL peritonitis in India, where such cases are increasingly prevalent.
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