대한신장학회

논문분류	춘계학술대회 초록집
제목	Aeromonas hydrophilia peritoneal dialysis-related peritonitis in Korea: case report
저자	Hyun Jin Kim* 1, Hyun Sun Park1, Eunsin Bae2, Hae Won Kim1, Beom Kim1, Dong-Young Lee1
출판정보	2016; 2016(1):
키워드	Aeromonas hydrophilia , Korea, peritoneal dialysis-related peritonitis
초록	Background: Peritonitis is a leading cause of morbidity and technique failure in patients doing peritoneal dialysis (PD). Aeromonas spp. have rarely been known as the causative pathogen in PD related peritonitis, and generally considered to be an opportunistic pathogen in immune compromised patients. Species of Aeromonas are gram-negative, rod-shaped bacteria mainly found in areas with a warm climate, and can survive in aerobic and anaerobic environments. In Korea there were a few reports that Aeromonas hydrophila caused spontaneous bacterial peritonitis in patients with liver cirrhosis, but only one case of PD-related peritonitis by Aeromonas hydrophila was reported. Methods: We report a case of peritonitis by A. hydrophila/caviae in a 56-year-old male with automatic peritoneal dialysis for 5 months. Results: A 56-year-old man with end-stage renal disease due to diabetes mellitus was admitted to our hospital because of complaining abdominal pain and cloudy dialysate from the day before the admission. We got to know that he put on a mask but did not hand washing after history taking. On physical examination, the patient had an acute ill-looking apperance with entire abdominal tenderness, but his vital signs were stable. The laboratory findings showed PD peritonitis: a WBC count of the peritoneal effluent was 121,157/μL with neutrophil predominance 89%. We started vancomycin and ceftazidime intraperitoneally without delay. Aeromonas hydrophila/caviae were cultured from peritoneal dialysate. Subsceptibility test showed that it was susceptible to ceftazidime and ciprofloxacin and then he was treated with ceftazidime intraperitoneal only. The patient was successfully treated without catheter removal, and was discharged on Day 8 with 7-days intraperitoneal antibiotics. Conclusion: We experienced Aeromonas hydrophilia/caviae peritoneal dialysis-related peritonitis. We report this case because PD-related peritonitis caused by these bacteria is still uncommon in Korea. Meanwhile, our case occured in this winter, and somewhat surrounded with insanitary environment.
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