Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hanghzou, People’s Republic of China.
Nephrol Dial Transplant. 2012 Apr;27(4):1639-44. doi: 10.1093/ndt/gfr504. Epub 2011 Sep 2.
Peritonitis caused by nontuberculous mycobacterium (NTM) is an important complication in peritoneal dialysis (PD) patients.
Cases of PD complicated by NTM peritonitis reported in the English language literature were identified in the PubMed database. The characteristics of these cases were reviewed.
In 41 articles, we identified 57 cases of PD-associated NTM peritonitis in patients ranging from 5 to 82 years. The prevalent clinical findings of these cases were fever, abdominal pain, cloudy fluid and an elevated leukocyte count in peritoneal fluid. These findings were non-specific and could not be differentiated from symptoms caused by Mycobacterium tuberculosis or other bacteria. The majority of these cases received empirical antibacterial therapy before diagnosis of NTM peritonitis. Isolates in more than half of the peritonitis cases were the rapidly growing Mycobacterium, Mycobacterium fortuitum (38.6%) and Mycobacterium chelonae (14.0%). In most cases, PD catheters were removed and experience with non-removal was limited.
Diagnosis of NTM infection should be considered in PD patients with peritonitis that are culture negative or refractory to empirical antibiotic therapy.
非结核分枝杆菌（NTM）引起的腹膜炎是腹膜透析（PD）患者的一个重要并发症。
在 PubMed 数据库中确定了以英文发表的与 NTM 性腹膜炎相关的 PD 病例。回顾了这些病例的特征。
在 41 篇文章中，我们共发现 57 例 PD 相关 NTM 性腹膜炎患者，年龄在 5 至 82 岁之间。这些病例的常见临床表现为发热、腹痛、混浊液体和腹腔液中白细胞计数升高。这些发现是非特异性的，无法与结核分枝杆菌或其他细菌引起的症状区分开来。在这些腹膜炎病例中，大多数在诊断为 NTM 性腹膜炎之前接受了经验性抗菌治疗。超过一半的腹膜炎病例分离出快速生长分枝杆菌，其中主要是偶然分枝杆菌（38.6%）和龟分枝杆菌（14.0%）。在大多数情况下，PD 导管被移除，而保留导管的经验有限。
对于培养阴性或对抗生素经验性治疗无反应的腹膜炎 PD 患者，应考虑 NTM 感染的诊断。
