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Recurrent bacterial peritonitis caused by Neisseria cinerea in a chronic ambulatory peritoneal dialysis (CAPD)
M J George1, J A DeBin, K E Preston
1Microbiology Laboratory, Samuel S. Stratton Veterans Affairs Medical Center, Albany, New York, USA.
Abstract:
We present an unusual case of recurrent (chronic ambulatory peritoneal dialysis) CAPD-associated peritonitis caused by Neisseria cinerea. Using DNA restriction fragment length polymorphism (RFLP) analysis, we determined that the recurrent infection was caused by reinfection with a different N. cinerea strain rather than relapse with the index strain and that the probable origin of the reinfecting organism was the patient's upper respiratory tract.
Insights
Recurrent peritonitis in chronic ambulatory peritoneal dialysis (CAPD) patients can be caused by new infections, not just relapses. This case highlights Neisseria cinerea originating from the upper respiratory tract as a potential cause.
Area of Science:
- Infectious Diseases
- Nephrology
- Microbiology
Background:
- Chronic ambulatory peritoneal dialysis (CAPD) is a common treatment for end-stage renal disease.
- CAPD-associated peritonitis is a serious complication that can lead to treatment failure.
- Recurrent peritonitis requires careful investigation to determine the causative agent and source.
Observation:
- A patient undergoing CAPD experienced recurrent peritonitis.
- The causative agent was identified as Neisseria cinerea.
- The infection recurred despite initial treatment.
Findings:
- DNA restriction fragment length polymorphism (RFLP) analysis revealed the recurrent peritonitis was due to reinfection with a distinct Neisseria cinerea strain.
- The initial and subsequent strains were different, ruling out relapse with the original organism.
- The upper respiratory tract was identified as the probable source of the reinfecting Neisseria cinerea strain.
Implications:
- This case underscores the importance of considering exogenous reinfection in recurrent CAPD peritonitis.
- Identifying the source of infection, such as the upper respiratory tract, is crucial for effective prevention and management strategies.
- Further research into the role of Neisseria species in CAPD peritonitis is warranted.