<i>Acinetobacter</i> <i>baumannii</i> peritoneal dialysis-related peritonitis: a review of 10 cases_West China Medical Journal

Authors：

TIAN Xiujuan ¹ , HE Juan ¹ , YANG Jun ¹ ,  LIU Hongchang ²

1. Department of Nephrology, the First Affiliated Hospital, Airforce Military University, Xi’an, Shaanxi 710032, P. R. China;
2. Department of Anesthesiology, the First Affiliated Hospital, Airforce Military University, Xi’an, Shaanxi 710032, P. R. China;

Corresponding author：

LIU Hongchang, Email: liuyoung2006@163.com

Keywords：

Acinetobacter baumannii; Peritoneal dialysis-related peritonitis; Drug resistance

DOI：

10.7507/1002-0179.202003158

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the clinical characteristics, treatment and outcomes of patients with Acinetobacter baumannii peritoneal dialysis-related peritonitis.Methods We retrospectively analyzed the clinical data of patients with Acinetobacter baumannii peritoneal dialysis-related peritonitis in the First Affiliated Hospital of Airforce Military University from January 2011 to December 2018. The clinical baseline data, treatment process, microbiological data, antibiotic susceptibility test of the bacterial isolates and outcomes were analyzed.Results A total of 10 patients were enrolled, including 4 males and 6 females. The average age of all patients was (44.90±17.03) years, the average age of peritoneal dialysis was (21.70±17.06) months. Seven cases were infected for the first time, and 3 cases were reinfected. The infections were mainly caused by mechanical failure of catheter connection system (3 cases) or enterogenous infection (3 cases). The main symptoms were abdominal pain (10 cases), fever (7 cases) and diarrhea (3 cases). Empirical anti-infective treatment was given after admission, only 1 case was effective, and the treatment of the other 9 cases were adjusted according to the results of drug sensitivity. Acinetobacter baumannii was sensitive to cefoperazone, carbapenem (meropenem, imipenem), quinolones (ciprofloxacin, levofloxacin), aminoglycosides (gentamicin) and polymyxin. Only one case was resistant to ceftazidime. Among the 10 patients, 8 cases were cured (continued peritoneal dialysis), 1 case died, and 1 case dropped out from peritoneal dialysis to hemodialysis.Conclusions Acinetobacter baumannii peritoneal dialysis-related peritonitis in this hospital is mainly caused by mechanical disturbance of catheter connection system or enterogenic infection. Appropriate measures, including aseptic standard operation, follow-up and effective anti-infective treatment, should be taken to decrease the incidence and mortality of Acinetobacter baumannii peritoneal dialysis-related peritonitis.

Citation： TIAN Xiujuan, HE Juan, YANG Jun, LIU Hongchang. Acinetobacter baumannii peritoneal dialysis-related peritonitis: a review of 10 cases. West China Medical Journal, 2021, 36(4): 483-487. doi: 10.7507/1002-0179.202003158 Copy

1.	Zimmerman AM. Peritoneal dialysis: increasing global utilization as an option for renal replacement therapy. J Glob Health, 2019, 9(2): 020316.
2.	Bolton L. Preventing peritoneal dialysis infections. Wounds, 2019, 31(6): 163-165.
3.	Najafi I, Alatab S, Atabak S, et al. Seventeen years’ experience of peritoneal dialysis in Iran: first official report of the Iranian peritoneal dialysis registry. Perit Dial Int, 2014, 34(6): 636-642.
4.	Szeto CC, Li PK, Johnson DW, et al. ISPD catheter-related infection recommendations: 2017 update. Perit Dial Int, 2017, 37(2): 141-154.
5.	Perl J, Fuller DS, Bieber BA, et al. Peritoneal dialysis-related infection rates and outcomes: results from the peritoneal dialysis outcomes and practice patterns study (PDOPPS). Am J Kidney Dis, 2020, 76(1): 42-53.
6.	Chao CT, Lee SY, Yang WS, et al. Citrobacter peritoneal dialysis peritonitis: rare occurrence with poor outcomes. Int J Med Sci, 2013, 10(9): 1092-1098.
7.	Friedman O, Jassal SV, Bargman JM. Acinetobacter peritoneal dialysis peritonitis: description and relation to the SPICE family of organisms. Perit Dial Int, 2008, 28(2): 195-197.
8.	Lye WC, Lee EJ, Leong SO, et al. Clinical characteristics and outcome of Acinetobacter infections in CAPD patients. Perit Dial Int, 1994, 14(2): 174-177.
9.	Li PK, Szeto CC, Piraino B, et al. ISPD peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int, 2016, 36(5): 481-508.
10.	Zelenitsky SA, Howarth J, Lagacé-Wiens P, et al. Microbiological trends and antimicrobial resistance in peritoneal dialysis-related peritonitis, 2005 to 2014. Perit Dial Int, 2017, 37(2): 170-176.
11.	Abraham G, Gupta A, Prasad KN, et al. Microbiology, clinical spectrum and outcome of peritonitis in patients undergoing peritoneal dialysis in India: results from a multicentric, observational study. Indian J Med Microbiol, 2017, 35(4): 491-498.
12.	Prasad KN, Singh K, Rizwan A, et al. Microbiology and outcomes of peritonitis in northern India. Perit Dial Int, 2014, 34(2): 188-194.
13.	张辉, 张小江, 徐英春,等. 2005—2014 年 CHINET 不动杆菌属细菌耐药性监测. 中国感染与化疗杂志, 2016, 16(4): 429-436.
14.	Lee CR, Lee JH, Park M, et al. Biology of Acinetobacter baumannii: pathogenesis, antibiotic resistance mechanisms, and prospective treatment options. Front Cell Infect Microbiol, 2017, 7: 55.
15.	Harding CM, Hennon SW, Feldman MF. Uncovering the mechanisms of Acinetobacter baumannii virulence. Nat Rev Microbiol, 2018, 16(2): 91-102.
16.	Boucher HW, Talbot GH, Bradley JS, et al. Bad bugs, no drugs: no ESKAPE! An update from the infectious diseases society of America. Clin Infect Dis, 2009, 48(1): 1-12.
17.	Kim YJ, Kim SI, Kim YR, et al. Carbapenem-resistant Acinetobacter baumannii: diversity of resistant mechanisms and risk factors for infection. Epidemiol Infect, 2012, 140(1): 137-145.
18.	Gordon NC, Wareham DW. Multidrug-resistant Acinetobacter baumannii: mechanisms of virulence and resistance. Int J Antimicrob Agents, 2010, 35(3): 219-226.
19.	Lin MF, Lan CY. Antimicrobial resistance in Acinetobacter baumannii: from bench to bedside. World J Clin Cases, 2014, 2(12): 787-814.
20.	Htay H, Cho Y, Pascoe EM, et al. Outcomes of Acinetobacter peritonitis in peritoneal dialysis patients: a multicenter registry analysis. Perit Dial Int, 2018, 38(4): 257-265.
21.	Li PH, Cheng VC, Yip T, et al. Epidemiology and clinical characteristics of Acinetobacter peritoneal dialysis-related peritonitis in Hong Kong-with a perspective on multi-drug and carbapenem resistance. Perit Dial Int, 2017, 37(2): 177-182.
22.	Zhang W, Wu YG, Qi XM, et al. Peritoneal dialysis-related peritonitis with Acinetobacter baumannii: a review of seven cases. Perit Dial Int, 2014, 34(3): 317-321.
23.	Galvao C, Swartz R, Rocher L, et al. Acinetobacter peritonitis during chronic peritoneal dialysis. Am J Kidney Dis, 1989, 14(2): 101-104.
24.	Lye WC, Lee EJ, Ang KK. Acinetobacter peritonitis in patients on CAPD: characteristics and outcome. Adv Perit Dial, 1991, 7: 176-179.
25.	Chao CT, Lee SY, Yang WS, et al. Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time. PLoS One, 2014, 9(10): e110315.

1. Zimmerman AM. Peritoneal dialysis: increasing global utilization as an option for renal replacement therapy. J Glob Health, 2019, 9(2): 020316.
2. Bolton L. Preventing peritoneal dialysis infections. Wounds, 2019, 31(6): 163-165.
3. Najafi I, Alatab S, Atabak S, et al. Seventeen years’ experience of peritoneal dialysis in Iran: first official report of the Iranian peritoneal dialysis registry. Perit Dial Int, 2014, 34(6): 636-642.
4. Szeto CC, Li PK, Johnson DW, et al. ISPD catheter-related infection recommendations: 2017 update. Perit Dial Int, 2017, 37(2): 141-154.
5. Perl J, Fuller DS, Bieber BA, et al. Peritoneal dialysis-related infection rates and outcomes: results from the peritoneal dialysis outcomes and practice patterns study (PDOPPS). Am J Kidney Dis, 2020, 76(1): 42-53.
6. Chao CT, Lee SY, Yang WS, et al. Citrobacter peritoneal dialysis peritonitis: rare occurrence with poor outcomes. Int J Med Sci, 2013, 10(9): 1092-1098.
7. Friedman O, Jassal SV, Bargman JM. Acinetobacter peritoneal dialysis peritonitis: description and relation to the SPICE family of organisms. Perit Dial Int, 2008, 28(2): 195-197.
8. Lye WC, Lee EJ, Leong SO, et al. Clinical characteristics and outcome of Acinetobacter infections in CAPD patients. Perit Dial Int, 1994, 14(2): 174-177.
9. Li PK, Szeto CC, Piraino B, et al. ISPD peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int, 2016, 36(5): 481-508.
10. Zelenitsky SA, Howarth J, Lagacé-Wiens P, et al. Microbiological trends and antimicrobial resistance in peritoneal dialysis-related peritonitis, 2005 to 2014. Perit Dial Int, 2017, 37(2): 170-176.
11. Abraham G, Gupta A, Prasad KN, et al. Microbiology, clinical spectrum and outcome of peritonitis in patients undergoing peritoneal dialysis in India: results from a multicentric, observational study. Indian J Med Microbiol, 2017, 35(4): 491-498.
12. Prasad KN, Singh K, Rizwan A, et al. Microbiology and outcomes of peritonitis in northern India. Perit Dial Int, 2014, 34(2): 188-194.
13. 张辉, 张小江, 徐英春,等. 2005—2014 年 CHINET 不动杆菌属细菌耐药性监测. 中国感染与化疗杂志, 2016, 16(4): 429-436.
14. Lee CR, Lee JH, Park M, et al. Biology of Acinetobacter baumannii: pathogenesis, antibiotic resistance mechanisms, and prospective treatment options. Front Cell Infect Microbiol, 2017, 7: 55.
15. Harding CM, Hennon SW, Feldman MF. Uncovering the mechanisms of Acinetobacter baumannii virulence. Nat Rev Microbiol, 2018, 16(2): 91-102.
16. Boucher HW, Talbot GH, Bradley JS, et al. Bad bugs, no drugs: no ESKAPE! An update from the infectious diseases society of America. Clin Infect Dis, 2009, 48(1): 1-12.
17. Kim YJ, Kim SI, Kim YR, et al. Carbapenem-resistant Acinetobacter baumannii: diversity of resistant mechanisms and risk factors for infection. Epidemiol Infect, 2012, 140(1): 137-145.
18. Gordon NC, Wareham DW. Multidrug-resistant Acinetobacter baumannii: mechanisms of virulence and resistance. Int J Antimicrob Agents, 2010, 35(3): 219-226.
19. Lin MF, Lan CY. Antimicrobial resistance in Acinetobacter baumannii: from bench to bedside. World J Clin Cases, 2014, 2(12): 787-814.
20. Htay H, Cho Y, Pascoe EM, et al. Outcomes of Acinetobacter peritonitis in peritoneal dialysis patients: a multicenter registry analysis. Perit Dial Int, 2018, 38(4): 257-265.
21. Li PH, Cheng VC, Yip T, et al. Epidemiology and clinical characteristics of Acinetobacter peritoneal dialysis-related peritonitis in Hong Kong-with a perspective on multi-drug and carbapenem resistance. Perit Dial Int, 2017, 37(2): 177-182.
22. Zhang W, Wu YG, Qi XM, et al. Peritoneal dialysis-related peritonitis with Acinetobacter baumannii: a review of seven cases. Perit Dial Int, 2014, 34(3): 317-321.
23. Galvao C, Swartz R, Rocher L, et al. Acinetobacter peritonitis during chronic peritoneal dialysis. Am J Kidney Dis, 1989, 14(2): 101-104.
24. Lye WC, Lee EJ, Ang KK. Acinetobacter peritonitis in patients on CAPD: characteristics and outcome. Adv Perit Dial, 1991, 7: 176-179.
25. Chao CT, Lee SY, Yang WS, et al. Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time. PLoS One, 2014, 9(10): e110315.

Previous Article
Comparison of the outcomes of kidney transplantation between Tibetan and Han recipients: a propensity score-matched analysis
Next Article
Genetic study of patients with Gitelman syndrome

West China Medical Journal

Acinetobacter baumannii peritoneal dialysis-related peritonitis: a review of 10 cases

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content