Sürekli Ayaktan Periton Diyalizi Hastasında Gelişen Siprofloksasinle Tedavi Edilen Chryseobacterium indologenes Peritoniti: Olgu Sunumu

Sürekli ayaktan periton diyalizi (SAPD) alan hastalarda peritonit, artan hastane ve antibiyotik maliyetleri ile bu hastalarda mortalite ve morbiditenin en önemli nedenlerinden biridir. Peritonit vakalarının çoğuna Gram pozitif bakteriler neden olmasına rağmen, bazen beklenmeyen mikroorganizmalar peritonite neden olabilir. Chryseobacterium indologenes, insan florasının doğada yaygın olarak bulunan bir üyesidir ve nadiren insan enfeksiyonlarına neden olur. Bu olgu sunumunda, iki yıldır SAPD alan Chryseobacterium indologenes’e bağlı peritonitli 68 yaşında erkek hastanın sunulması amaçlanmıştır. Hasta intravenöz ilaveten intraperitoneal siprofloksasin tedavisine iyi cevap verdi. Bu durumda, periton diyalizi kateterinin çıkarılmasına gerek kalmadı. Chryseobacterium indologenes SAPD ile ilişkili, oldukça nadir görülen bir peritonit nedenidir. Bu mikroorganizma kaynaklı peritonit, periton kateterinin çekilmesine gerek kalmadan intravenöz artı intraperitoneal antibiyotiklerle başarılı bir şekilde tedavi edilebilir.

Anahtar Kelimeler:

Chryseobacterium indologenes, sürekli ayaktan periton diyalizi, siprofloksasin, peritonit

Chryseobacterium indologenes Peritonitis in Continuous Ambulatory Peritoneal Dialysis Patient Treated with Ciprofloxacin: Case Report

Peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD) is one of the most important causes of increased hospital and antibiotic costs, and mortality and morbidity in these patients. Although the majority of peritonitis cases are caused by Gram positive bacteria, sometimes unexpected microorganism can cause peritonitis. Chryseobacterium indologenes is a member of the human flora widely found in nature and rarely causes of human infections. In this case report, it is aimed to present 68 year-old male patient with peritonitis due to Chryseobacterium indologenes who has been receiving CAPD for two years. The patient responded well to intravenous plus intraperitoneal ciprofloxacin therapy. There was no need to remove the peritoneal dialysis catheter, in this case. Chryseobacterium indologenesis is an extremely rare cause of peritonitis associated with CAPD. This microorganism-induced peritonitis can be treated successfully with intravenous plus intraperitoneal antibiotics without need for withdrawal of the peritoneal catheter.

Keywords:

Chryseobacterium indologenes, continuous ambulatory peritoneal dialysis, ciprofloxacin, peritonitis.,

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Laxton MK. Peritoneal dialysis: an effective yet underused renal replacement therapy. JAAPA. 2016;29(5):40-6.
Steinberg JP, Burd EM. Other gram-gegative and gram-variable bacilli. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Saunders; 2010. p.3022-3.
Hsueh PR, Teng LJ, Yang PC, Ho SW, Hsieh WC, Luh KT. Increasing incidence of nosocomial Chryseobacterium indologenes infections in Taiwan. Eur J Clin Microbiol Infect Dis. 1997;16(8):568-74.
Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, et al. ISPD Peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int. 2016;36(5):481-508.
Liakopoulos V, Nikitidou O, Kalathas T, Roumeliotis S, Salmas M, Eleftheriadis T. Peritoneal dialysis-related infections recommendations: International Society of Peritoneal Dialysis (ISPD) 2016 update. What is new? Int Urol Nephrol. 2017;49(12):2177-84.
Mirza HC, Tuncer Ö, Ölmez S, Şener B, Tuğcu GD, Özçelik U, et al. Clinical strains of Chryseobacterium and Elizabethkingia spp. isolated from pediatric patients in a university hospital: performance of MALDI-TOF MS-based identification, antimicrobial susceptibilities, and baseline patient characteristics. Microb Drug Resist. 2018;24(6):816-21.
Aykac K, Ozsurekci Y, Tuncer O, Sancak B, Cengiz AB, Kara A, et al. Six cases during 2012-2015 and literature review of Chryseobacterium indologenes infections in pediatric patients. Can J Microbiol. 2016;62(10):812-9.
Choi MW, Oh SS, Choi MR, Lee JH, Yang HJ, Sun IO, et al. Peritoneal dialysis-associated peritonitis caused by Chryseobacterium indologenes. Korean J Med. 2018;93(1):65-7.
Afshar M, Nobakht E, Lew SQ. Chryseobacterium indologenes peritonitis in peritoneal dialysis. BMJ Case Rep. 2013;2013:bcr2013009410.
Yoon JS, Hwang EA, Chang MH, Park WY, Jin KB, Han SY, et al. Peritonitis by Chryseobacterium indologenes and Sphingomonas paucimobilis in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD). Korean J Nephrol. 2007;26(6):801-5.
Carvalho TJ, Branco PQ, Martins AR, Gaspar A. Chryseobacterium indologenesperitonitis in a peritoneal dialysis patient. BMJ Case Rep. 2018;11(1):e227713.
Cheng WL, Chen K, Hung YC. Chryseobacterium indologenes peritonitis in peritoneal dialysis: a rare and difficult case. Acta Nephrologica. 2018;32(2):89-92.