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논문분류	춘계학술대회 초록집
제목	Microbacterium Peritonitis in Peritoneal Dialysis: A Case Report
저자	Hae Ri Kim
출판정보	2024; 2024(1):
키워드
초록	Peritonitis is a common complication in peritoneal dialysis patients, necessitating tailored treatment based on the causative pathogen. Microbacterium spp., a Gram-positive bacillus, poses challenges due to limited reported cases and susceptibility data. I present a case of Microbacterium aurum peritonitis in a 53-year-old female undergoing peritoneal dialysis. The patient, with a 2-year peritoneal dialysis history and no prior peritonitis, complained of abdominal pain and inadequate dialysate drainage. Vital signs were stable, No fever. Initial laboratory results showed serum complete blood count was 7.40 X103/μL, Hb 9.8 g/dL, and CRP 0.1 mg/dL. Peritoneal fluid analysis revealed leukocytosis (241×106/L, PMN 55.9%). Empirically, intraperitoneal cefazolin and ceftazidime were administered, initially improving symptoms. However, persistent WBC elevation peritoneal dialysate analysis led to a switch to intraperitoneal meropenem and vancomycin on the 5th day. Limited Microbacterium susceptibility data prompted cautious antibiotic choices. Despite discontinuing meropenem due to suspected resistance, the patient experienced discomfort and reduced drainage, prompting its reintroduction. On the 7th day, Microbacterium aurum was still identified in peritoneal dialysate culture, but the patient remained asymptomatic. Medication was maintained without catheter removal. Cultures from the 10th day onwards revealed no bacteria. Meropenem and vancomycin were continued for 21 days, resulting in no symptom recurrence. This case highlights the complexities of Microbacterium peritonitis management, emphasizing the need for individualized treatment strategies in the absence of standardized susceptibility data.
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