Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
Perit Dial Int. 2010 Jan-Feb;30(1):99-104. doi: 10.3747/pdi.2008.00227.
The micro-organisms involved in continuous ambulatory peritoneal dialysis (CAPD) peritonitis are usually gram-positive cocci of cutaneous origin. Campylobacter species are rarely implicated as a cause of CAPD peritonitis.
A retrospective review of 100 consecutive episodes of peritonitis was carried out in patients undergoing CAPD or automated PD in our hospital from June 2004 to December 2007. Collection of dialysate and microbial examination was done according to ISPD guidelines. Identification of the organism was made on the basis of Gram smear morphology, positive oxidase test, and biochemical reactions using API Campi (BioMérieux, Marcy l'Etoile, France). Susceptibility testing was performed using E-test (AB Biodisc, Solna, Sweden) and confirmation was done by molecular techniques.
The causative organisms in 23 of these episodes were gram-negative bacteria, 3 of which were identified as Campylobacter species using special culture techniques. The clinical presentation in our patients with Campylobacter peritonitis (CP) was different from that of patients with peritonitis from other organisms in that all 3 had diarrhea at presentation. Among patients with CP, no subspecies-specific feature was identified. Good response to the antibiotic treatment was observed; there was no relapse/recurrence of peritonitis, catheter loss, or death.
Incidence of CP remains low and, regardless of the subtype, clinical outcomes are better than those seen with other gram-negative bacteria such as Pseudomonas. The presence of diarrhea at presentation and the finding of curved or spiral gram-negative bacilli in the Gram smear of peritoneal dialysis effluent should make one think of CP. The use of appropriate microbiology techniques in this situation will increase the isolation of this organism.
与持续性非卧床腹膜透析（CAPD）腹膜炎相关的微生物通常是源自皮肤的革兰阳性球菌。弯曲杆菌种很少被认为是 CAPD 腹膜炎的病因。
对 2004 年 6 月至 2007 年 12 月期间在我院接受 CAPD 或自动化 PD 的 100 例连续性腹膜炎患者的 100 例连续发作进行回顾性分析。根据 ISPD 指南收集腹透液并进行微生物检查。根据革兰氏染色形态、阳性氧化酶试验和使用 API Campi（法国马西-勒泰尔的生物梅里埃）的生化反应来确定生物体的鉴定。使用 E-测试（AB Biodisc，索尔纳，瑞典）进行药敏试验，并通过分子技术进行确认。
在这 23 例中，有 23 例的病原体是革兰氏阴性细菌，其中 3 例使用特殊培养技术鉴定为弯曲杆菌种。我们的弯曲杆菌性腹膜炎（CP）患者的临床表现与其他病原体引起的腹膜炎不同，这 3 例患者在就诊时均出现腹泻。在 CP 患者中，未发现亚种特异性特征。抗生素治疗效果良好；无腹膜炎复发/再发、导管丢失或死亡。
CP 的发病率仍然较低，并且无论亚型如何，临床结果都优于其他革兰氏阴性菌（如铜绿假单胞菌）。在出现腹泻和在革兰氏染色的腹膜透析液中发现弯曲或螺旋状革兰氏阴性杆菌时，应考虑 CP。在这种情况下使用适当的微生物学技术将增加该生物体的分离。
