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POS-718 Case of Kocuria spp. induced peritoneal dialysis related peritonitis
Singh, Arvind Ryder, Sarah Polturi, Madhu Fredlund, Martyn
Singh, Arvind
Ryder, Sarah
Polturi, Madhu
Fredlund, Martyn
Date
2022-02-18
Journal Title
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Conference Abstract
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Abstract
Introduction
Peritonitis is a serious complication of peritoneal dialysis (PD) and is commonly caused by coagulase negative staphylococcal species and staphylococcus aureus. PD related peritonitis contributes to death in up to 8.6% of patients and often results in transition to haemodialysis. In this case we illustrate a rare presentation of Kocuria causing recurrent, treatment resistant peritonitis that resulted in eventual cessation of PD and switch to haemodialysis. Kocuria species are commonly found as skin commensals on human and other mammal skin and rarely cause systemic infections in humans. Despite only 12 case reports of Kocuria induced peritonitis in patients undergoing PD having been reported, Kocuria is increasingly being recognised as an important pathogen in humans.
Methods
We describe an 84 year old woman with end stage renal failure of an unknown aetiology who was commenced on PD in 2016.
Results
The patient was maintained on PD until November 2019 where she was admitted with Acinetobacter induced peritonitis that was treated with oral quinolones. In March 2021 she was admitted again with Kocuria Spp. induced peritonitis where she was treated with intraperitoneal vancomycin and oral ciprofloxacin. Despite displaying adequate sensitivities to these antibiotics, Kocuria Spp. continued to be cultured from her peritoneal fluid. As medical management of her peritonitis failed her PD line was removed in April 2021 and she was commenced on haemodialysis.
Conclusions
This case is a good example of a rare microbe causing PD related peritonitis that, despite displaying wide ranging sensitives during laboratory testing, was resistant to intraperitoneal antibiotics. This case adds to the growing literature suggesting that Kocuria Spp. are important causative organisms of human disease and should be considered when designing treatment pathways for peritoneal dialysis related peritonitis.
Citation
Tuck, A., Singh, A., Ryder, S., Polturi, M., & Fredlund, M. (2022). POS-718 case of Kocuria spp. induced peritoneal dialysis related peritonitis. Kidney International Reports, 7(2), S309.
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CC BY-NC-ND 4.0