Giladi M, Lee B E, Berlin O G, Panosian C B
Department of Medicine, UCLA School of Medicine.
Am J Kidney Dis. 1992 Jun;19(6):597-9. doi: 10.1016/s0272-6386(12)80841-9.
Mycobacterium kansasii was isolated from the peritoneal fluid, peritoneal biopsy, and the Tenckhoff catheter of a 62-year-old woman undergoing continuous ambulatory peritoneal dialysis (CAPD) who presented with the clinical picture of peritonitis. To the best of our knowledge, this is the first case of CAPD-associated peritonitis caused by M kansasii. Routine susceptibility tests using standard concentrations of isoniazid indicated isoniazid resistance; however, the organism was inhibited in vitro by a higher concentration of this drug. The patient responded to combination therapy with isoniazid and rifampin, as well as removal of the catheter. This report emphasizes the importance of mycobacterial cultures, in certain circumstances, in patients with CAPD-associated peritonitis and the utility of quantitative in vitro susceptibility testing.
堪萨斯分枝杆菌是从一名62岁持续非卧床腹膜透析(CAPD)女性的腹腔积液、腹膜活检组织及Tenckhoff导管中分离出来的,该患者表现出腹膜炎的临床症状。据我们所知,这是首例由堪萨斯分枝杆菌引起的与CAPD相关的腹膜炎病例。使用标准浓度异烟肼进行的常规药敏试验显示对异烟肼耐药;然而,该菌在体外被更高浓度的此药所抑制。患者对异烟肼和利福平联合治疗以及导管移除有反应。本报告强调了在某些情况下,对与CAPD相关的腹膜炎患者进行分枝杆菌培养的重要性以及体外定量药敏试验的实用性。