대한신장학회

Skip Navigation: Skip to contents

KOR
ENG
전체메뉴보기

간행물 검색

현재 페이지 경로

HOME
간행물
간행물 검색

논문분류	춘계학술대회 초록집
제목	A Case Report Of Enterococcus Casseliflavus Peritoneal Dialysis-Associated Peritonitis
저자	Sze Mun Tan
출판정보	2024; 2024(1):
키워드
초록	Enterococci which are resistant to vancomycin are becoming important pathogens. We report the first case of peritoneal dialysis (PD) related peritonitis caused by Enterococcus casseliflavus in Hospital Queen Elizabeth (HQE), a tertiary hospital in Sabah, Malaysia. Our patient is a 61-year-old gentleman, who was on continuous ambulatory peritoneal dialysis (CAPD) for 8 months. The likely cause for his end stage kidney disease (ESKD) was diabetes mellitus. Despite his poor eyesight, he was still performing PD exchanges. He was admitted for Klebsiella pneumoniae PD peritonitis. He was given the appropriate antibiotic and had responded well. However, on day 11 of treatment, he had cloudy PD effluent again. Sample of PD effluent was collected and was sent for culture. Blood agar grew colonies which stained positive for Gram positive cocci in chain and possessed yellowish pigmentation on a cotton swab. The colony was identified as Enterococcus casseliflavus by VITEK® MS bioMérieux and susceptibility was tested by using VITEK® 2 AST card bioMérieux. The organism was resistant to vancomycin, however, it had confirmed susceptibility to ampicillin and gentamicin. Our patient was given three weeks of intraperitoneal ampicillin and was successfully treated without the need of removing his PD catheter. E. casseliflavus possesses the vanC ligase gene, which encodes for intrinsic resistance to vancomycin. Similarly, the vanC ligase gene had also been described in E. mundtii and E. flavescens. They usually demonstrate susceptibility to ampicillin. Hence, in the case of E. casseliflavus infections, ampicillin is a suitable antimicrobial agent. In 2023, there were 9 cases of Enterococcal peritonitis in HQE, in which 1 required PD catheter removal. We wish to highlight that although an organism demonstrated resistance to vancomycin, it does not necessarily mean that high-end antibiotic such as linezolid is needed. The usage of antibiotic should still be guided by sensitivity testing.
원문(PDF)	PDF 원문보기

목록

위로가기