ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2022 and some content may be unavailable. To unlock all content for 2022, please visit the archives.

Abstract: PUB140

Challenges of Treating Stenotrophomonas maltophilia Peritonitis in a Peritoneal Dialysis Patient With Suprapubic Catheter

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Hongalgi, Krishnakumar D., Albany Medical Center, Albany, New York, United States
  • Abid, Sidrah, Albany Medical Center, Albany, New York, United States
  • Beers, Kelly H., Albany Medical Center, Albany, New York, United States
  • Mehta, Swati, Albany Medical Center, Albany, New York, United States
Introduction

Peritoneal dialysis (PD) is a preferred home modality of treatment for end stage kidney disease (ESKD). Peritonitis is the most feared complication associated with long term PD and is associated with increased morbidity and mortality. We report a rare case of stenotrophomonas maltophilia peritonitis in a patient with chronic suprapubic catheter.

Case Description

59-year-old male with ESKD with history of suprapubic catheter had beta hemolytic strep peritonitis followed by another episode of coagulase negative staph peritonitis which were treated outpatient with intraperitoneal (IP) antibiotics. He was admitted to the hospital later with another episode of abdominal pain and cloudy peritoneal effluent. He was hemodynamically stable, afebrile and had mild leukocytosis without left shift. Empiric treatment with IP vancomycin and ceftazidime was started. Peritoneal culture grew >100,000 colonies of stenotrophomonas maltophilia resistant to ceftazidime, sensitive to levofloxacin and trimethoprim/sulfamethoxazole. Ceftazidime was discontinued and patient was started on oral levofloxacin and trimethoprim/sulfamethoxazole with plan for 21 days of treatment. PD catheter was left in-situ and PD was continued without interruption. Patient improved clinically and was discharged with outpatient follow up. Levofloxacin was eventually discontinued after 2 weeks due to prolonged QT interval.

Discussion

PD has been established as a safe modality of kidney replacement therapy empowering patients in selfcare. PD catheter associated peritonitis is common cause of treatment failure as it can result in loss of PD catheter. Stenotrophomonas maltophilia is a rare cause of peritonitis with reported loss of PD catheter in over half of cases. Treating peritonitis in a patient with suprapubic catheters is challenging. Our patient was successfully treated with levofloxacin and trimethoprim/sulfamethoxazole without necessitating the removal of his PD catheter.