Clinical course of peritonitis due to Pseudomonas species complicating peritoneal dialysis: A review of 104 cases

Abstract

Recent antibiotic therapy is the major risk factor for peritonitis due to the Pseudomonas species. Exit site infection and recent antibiotic therapy are associated with poor therapeutic response to antibiotics. When the therapeutic response is suboptimal, early Tenckhoff catheter removal may help preserve the peritoneum for further peritoneal dialysis. Elective Tenckhoff catheter exchange after clearing up the peritoneal dialysis effluent may also reduce the likelihood of relapse. It is desirable to use third-generation cephalosporin in the initial antibiotic regimen for peritonitis treatment in localities with a high incidence of peritonitis due to the Pseudomonas species.

Pseudomonas putida war wound infection in a US Marine: A case report and review of the literature

“…8,10,11,13,15,22,24,26,30,34,36 Based on our review of the literature, it is unclear if the underlying immunosuppression alone is a risk factor to infection with P. putida since a majority (93%) of immunosuppressed individuals also had invasive medical devices, which may have been their predominant risk factor. 10,11,15,22,24,26,30,34,36 Further, even in this critically ill population, there were seven cases in which patients spontaneously cleared the organism with removal of the device. 10,26 Lending support to medical device-related risk is a report from one study of immunosuppressed individuals which noted an increase in P. putida septicaemia after an institution-wide increase in the use of indwelling central venous catheters.…”

Acidosis Potentiates the Host Proinflammatory Interleukin-1β Response to Pseudomonas aeruginosa Infection

“…In order to test whether acidic pH within a microenvironment leads to higher IL-1␤ production in vivo, we used a modification of an established P. aeruginosa peritonitis model that mimics iatrogenic infections such as those acquired during continuous ambulatory peritoneal dialysis (13,60). Thioglycolatestimulated C57BL/6 mice were injected intraperitoneally with PA14 in the presence of buffered medium in order to temporarily shift the peritoneal microenvironment to a desired pH.…”

Peritonitis due to Pseudomonas putida in a Patient Receiving Automated Peritoneal Dialysis

“…A major risk factor for peritonitis with Pseudomonas species is recent antibiotic therapy [1]. In hospitalized patients, invasive interventions such as placement of intravascular devices, urinary catheterization and intubation are known risk factors for Pseudomonas infections [6].…”

“…In a large series from China, Pseudomonas was the only etiologic agent in 104 of 850 (12%) CAPD-associated peritonitis cases. Of these, only three cases (2.9%) were due to P. putida, but their clinical course and outcomes were also not reported [1]. Lew et al reported the first case of CAPD-associated P. putida peritonitis outside of Asia.…”

“…Peritonitis due to Pseudomonas species is a serious complication in peritoneal dialysis (PD) patients [1]. Pseudomonas aeruginosa is the most important and thoroughly studied organism of the species in the genus Pseudomonas [2].…”