TITLE:
Successful Treatment of Peritoneal Dialysis Related Peritonitis from Multi-Drug Resistant Sphingomonas paucimobilis with Combination Therapy: A Case Report
AUTHORS:
Gennaro Argentino, Silvio Borrelli, Ciro Paglionico, Andrea Camocardi, Mario Iorio, Alessandra Antonia Mele, Andrea Pota, Adelia Sagliocca, Stefania Brancaccio, Lucia Di Micco
KEYWORDS:
Sphingomonas paucimobilis, Peritoneal Dialysis, Peritonitis, Antibiotic Therapy
JOURNAL NAME:
Open Journal of Nephrology,
Vol.12 No.2,
June
30,
2022
ABSTRACT: Sphingomonas paucimobilis is an emerging gram-negative aerobic bacterium, generally causing infections in immunocompromised patients. Few data are available about peritonitis in peritoneal dialysis due to this pathogen. The clinical courses and outcomes of peritonitis are variable, with a high frequency of catheter removal and peritoneal dialysis withdrawal. No guidelines are available for the treatment of Sphingomonas paucimobilis related peritonitis, due to its emerging role as pathogen, the high antibiotic resistance and unpredictable antibiotic sensitivity. Here, we describe a case of Sphingomonas paucimobilis peritonitis in a 52-year-old diabetic patient in Continuous Cycler-Assisted Peritoneal Dialysis (CCPD) for 4 months, successfully treated with a combined intraperitoneally administration of meropenem (250 mg/L) and ciprofloxacin (100 mg/L) for 21 days. No hospital admission and change of peritoneal dialysis scheme were needed; no relapses of peritonitis were observed during 18 months of follow-up.