Peritoneal Dialysis-Related Peritonitis from Carbapenemase-Producing Klebsiella pneumoniae with OXA-48 Type Gene

Area of Science:

• Nephrology
• Infectious Diseases
• Microbiology

Background:

• Automated peritoneal dialysis (APD) is a common renal replacement therapy.
• Peritonitis is a serious complication of peritoneal dialysis (PD).
• The rise of multi-drug resistant organisms (MDROs) poses a significant challenge in managing PD-related infections.

Observation:

• A rare case of peritonitis caused by carbapenemase-producing Enterobacteriaceae (CPE) in a patient undergoing APD is presented.
• The patient's clinical condition did not improve despite appropriate antibiotic therapy.
• Peritoneal dialysis (PD) catheter removal was required due to the persistent infection and patient's deteriorating condition.

Findings:

• Carbapenemase-producing Enterobacteriaceae represent a rare but serious cause of PD peritonitis.
• Treatment failure and the need for PD catheter removal can occur even with targeted antimicrobial agents.
• Antimicrobial resistance in PD peritonitis is an increasing concern, complicating patient management.

Implications:

• This case underscores the critical need for vigilance regarding MDROs in APD patients.
• Effective management strategies for CPE peritonitis in PD patients require further investigation.
• The findings highlight the importance of considering catheter removal in refractory PD peritonitis, especially with resistant organisms.