Successful Treatment of <i>Alcaligenes xylosoxidans</i> in Automated Peritoneal Dialysis-Related Peritonitis

Ledger, Séadna; Cordy, P. E.

doi:10.1177/089686080702700524

Cited by 10 publications

(9 citation statements)

References 10 publications

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“…This patient recovered by antimicrobial therapy alone and did not require catheter removal similar to previous patient reported by Kavuncuoglu et al [ 1 ]. However another species of Alcaligenes, Alcaligenes xylosoxidans has been reported to cause peritonitis in PD patients previously [ 2 ]. The majority of these patients required catheter removal because of resistance to most antibiotic therapies.…”

Section: Discussionmentioning

confidence: 99%

Unusual causes of peritonitis in a peritoneal dialysis patient: Alcaligenes faecalis and Pantoea agglomerans

Kahveci

Aşıcıoğlu

Tigen

et al. 2011

Annals of Clinical Microbiology and Antimicrobials

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Section: Discussionmentioning

confidence: 99%

Unusual causes of peritonitis in a peritoneal dialysis patient: Alcaligenes faecalis and Pantoea agglomerans

Kahveci

Aşıcıoğlu

Tigen

et al. 2011

Annals of Clinical Microbiology and Antimicrobials

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“…63,64,66 Achromobacter and Alcaligenes thrive in aqueous environments and cases of nosocomial sepsis arising from contaminated intravenous and hemodialysis fluids have been reported. 64,67 A. xylosoxidans and A. faecalis have also been isolated from infections in the ear, eye, urinary tract, abdomen, lungs, central nervous system, and blood, most commonly due to infected intravascular catheters. 63 Chronic colonization with A. xylosoxidans in cystic fibrosis patients has been associated with declines in lung function and a greater risk of pulmonary exacerbation.…”

Section: Introductionmentioning

confidence: 99%

An Overview of the Treatment of Less Common Non–Lactose‐Fermenting Gram‐Negative Bacteria

et al. 2020

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Stenotrophomonas maltophilia, Burkholderia cepacia complex, Elizabethkingia spp., Chryseobacterium spp., Achromobacter spp., and Alcaligenes spp. are less‐common non–lactose‐fermenting bacteria that have emerged as important opportunistic pathogens. Patients at the highest risk for these infections include the immunocompromised, those with cystic fibrosis, and the critically ill. These opportunistic pathogens are frequently drug resistant through the expression of β‐lactamases, multidrug efflux pumps, aminoglycoside‐modifying enzymes, and target site alterations discussed in detail throughout this review. As a result, treatment is extremely challenging. For each pathogen, this review will examine the epidemiology, mechanisms of resistance, and in vitro and in vivo data including that for novel β‐lactam/β‐lactamase inhibitors and cefiderocol. Treatment recommendations are provided based on the available literature.

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“…There was a single case report on the use of IP imipenem for the treatment of APD-associated peritonitis caused by Alcaligenes xyloxidans. 17 The author employed IP imipenem 1 g twice daily and allowed to dwell for 6 h followed by five cycles of exchanges. This resulted in resolution of peritonitis.…”

Section: Resultsmentioning

confidence: 99%

Pharmacokinetics of culture-directed antibiotics for the treatment of peritonitis in automated peritoneal dialysis: A systematic narrative review

et al. 2021

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The objectives of this study were to provide a summary of the pharmacokinetic data of some intraperitoneal (IP) antibiotics that could be used for both empirical and culture-directed therapy, as per the ISPD recommendations, and examine factors to consider when using IP antibiotics for the management of automated peritoneal dialysis (APD)-associated peritonitis. A literature search of PubMed, EMBASE, Scopus, MEDLINE and Google Scholar for articles published between 1998 and 2020 was conducted. To be eligible, articles had to describe the use of antibiotics via the IP route in adult patients ≥18 years old on APD in the context of pharmacokinetic studies or case reports/series. Articles describing the use of IP antibiotics that had been recently reviewed (cefazolin, vancomycin, gentamicin and ceftazidime) or administered for non-APD-associated peritonitis were excluded. A total of 1119 articles were identified, of which 983 abstracts were screened. Seventy-three full-text articles were assessed for eligibility. Eight records were included in the final study. Three reports had pharmacokinetic data in patients on APD without peritonitis. Each of cefepime 15 mg/kg IP, meropenem 0.5 g IP and fosfomycin 4 g IP given in single doses achieved drug plasma concentrations above the minimum inhibitory concentration for treating the susceptible organisms. The remaining five records were case series or reports in patients on APD with peritonitis. While pharmacokinetic data support intermittent cefepime 15 mg/kg IP daily, only meropenem 0.5 g IP and fosfomycin 4 g IP are likely to be effective if given in APD exchanges with dwell times of 15 h. Higher doses may be required in APD with shorter dwell times. Information on therapeutic efficacy was derived from case reports/series in individual patients and without therapeutic drug monitoring. Until more pharmacokinetic data are available on these antibiotics, it would be prudent to shift patients who develop peritonitis on APD to continuous ambulatory peritoneal dialysis, where pharmacokinetic information is more readily available.

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Successful Treatment of Alcaligenes xylosoxidans in Automated Peritoneal Dialysis-Related Peritonitis

Cited by 10 publications

References 10 publications

Unusual causes of peritonitis in a peritoneal dialysis patient: Alcaligenes faecalis and Pantoea agglomerans

Unusual causes of peritonitis in a peritoneal dialysis patient: Alcaligenes faecalis and Pantoea agglomerans

An Overview of the Treatment of Less Common Non–Lactose‐Fermenting Gram‐Negative Bacteria

Pharmacokinetics of culture-directed antibiotics for the treatment of peritonitis in automated peritoneal dialysis: A systematic narrative review

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