Diphtheroid peritonitis associated with continuous ambulatory peritoneal dialysis

Area of Science:

• Nephrology
• Infectious Diseases
• Microbiology

Background:

• Continuous ambulatory peritoneal dialysis (CAPD) is a common treatment for kidney failure.
• Peritonitis, an infection of the peritoneum, is a serious complication of CAPD.
• Diphtheroid bacteria are emerging as opportunistic pathogens in immunocompromised individuals.

Purpose of the Study:

• To investigate the role of diphtheroid bacteria in CAPD-associated peritonitis.
• To describe the clinical presentation, treatment challenges, and outcomes of such infections.
• To emphasize the diagnostic difficulties and clinical significance of diphtheroid peritonitis.

Main Methods:

• Case series of five CAPD patients who developed peritonitis.
• Clinical data collection including symptoms, treatment, and outcomes.
• Microbiological analysis of peritoneal fluid and catheter sites, noting culture difficulties.

Main Results:

• All five patients presented with peritonitis linked to diphtheroid bacteria.
• Peritoneal catheter exit site inflammation or discharge was a common preceding sign.
• Antimicrobial therapy alone was ineffective; catheter removal was required for resolution.
• Laboratory cultures for diphtheroids were challenging, often requiring prolonged incubation.

Conclusions:

• Diphtheroid bacteria are significant opportunistic pathogens in CAPD patients.
• Culture-negative CAPD peritonitis should prompt investigation for diphtheroid bacteria.
• Prompt diagnosis and management, potentially including catheter removal, are crucial for successful treatment.