Division of Nephrology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, PR China.
Perit Dial Int. 2013 Mar-Apr;33(2):189-94. doi: 10.3747/pdi.2011.00323. Epub 2012 Oct 2.
Peritoneal dialysis-associated peritonitis secondary to Campylobacter organisms is uncommon. Few studies have assessed either treatment or clinical outcomes.
We reviewed all Campylobacter peritonitis episodes occurring in a single dialysis unit from 1994 to 2011.
During the study period, 12 episodes of Campylobacter peritonitis (0.45% of all peritonitis episodes) were recorded. Diarrhea was uncommon (8.3%). The overall primary response rate was 91.7%; the complete cure rate was 75.0%. Among 6 patients who failed to respond to standard antibiotics by day 5, all improved after administration of an oral macrolide (erythromycin or clarithromycin). Of those 6 patients, 5 experienced a complete cure, and 1 patient experienced relapse of culture-negative peritonitis. No patient required Tenckhoff catheter removal or temporary hemodialysis support. The 30-day mortality was 0%.
Campylobacter peritonitis might not respond to first-line conventional antibiotics, and an oral macrolide is recommended if Campylobacter is confirmed. The findings from our analysis do not support the use of fluoroquinolone, which is associated with a high resistance rate.
由弯曲杆菌引起的与腹膜透析相关的腹膜炎并不常见。很少有研究评估过治疗或临床结果。
我们回顾了 1994 年至 2011 年期间在一个透析单位中发生的所有弯曲杆菌性腹膜炎病例。
在研究期间，共记录了 12 例弯曲杆菌性腹膜炎（占所有腹膜炎病例的 0.45%）。腹泻并不常见（8.3%）。总的初次治疗反应率为 91.7%；完全治愈率为 75.0%。在 6 名在第 5 天对标准抗生素治疗无反应的患者中，所有患者在给予口服大环内酯类药物（红霉素或克拉霉素）后均有所改善。在这 6 名患者中，5 名患者完全治愈，1 名患者出现文化阴性腹膜炎复发。没有患者需要移除 Tenckhoff 导管或接受临时血液透析支持。30 天死亡率为 0%。
弯曲杆菌性腹膜炎可能对一线常规抗生素治疗无反应，如果确认存在弯曲杆菌感染，建议使用口服大环内酯类药物。我们的分析结果不支持使用氟喹诺酮类药物，因为此类药物的耐药率很高。
