Chaughtai Saira, Gandhi Bhavika, Chaughtai Zeeshan, Tarina Dana, Hossain Mohammad A, Asif Arif
Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, 1945 Route 33, Neptune, NJ 07753, USA.
Case Rep Med. 2018 Sep 19;2018:3537283. doi: 10.1155/2018/3537283. eCollection 2018.
Recently, the incidence of () associated infection has increased significantly in hospital and ambulatory care settings in parallel to the increasing use of inappropriate antibiotics. According to the CDC, approximately 83,000 patients who developed . experienced at least one recurrence and 29,000 died within 30 days of the initial diagnosis. Patients on dialysis (particularly peritoneal dialysis) are predisposed to this infection due to an inherent immunocompromised state and transmural translocation of the bacteria due to the close association of gastrointestinal tract and peritoneal cavity. . infection in peritoneal dialysis patients is problematic from two aspects: (1) because dialysis patients are immunocompromised, the infection can be devastating and (2) infection directly interferes with their renal replacement therapy. In this article, we present a case of peritoneal dialysis (PD)-related peritonitis caused by -associated diarrhea and colitis. In this patient, the peritonitis was caused by transmural translocation of the enteric bacteria. While the peritoneal fluid culture did not grow the organism (possibly because of prior empiric broad-spectrum antibiotics use), the positive PCR on stool analysis suggested -related peritonitis, along with the rapid clinical improvement induced by . -directed therapy (metronidazole) and discontinuation of broad-spectrum antibiotics. The patient was successfully treated with metronidazole without PD catheter removal. . infection is common and frequently internists are the first contact with such patients. This article highlights . infection in a PD patient and raises awareness of this infection in dialysis patients.
最近，随着不恰当抗生素使用的增加，医院和门诊护理环境中与（）相关感染的发生率显著上升。根据美国疾病控制与预防中心（CDC）的数据，约83000例发生（）的患者至少经历了一次复发，并且在初次诊断后的30天内有29000人死亡。透析患者（尤其是腹膜透析患者）由于其固有的免疫功能低下状态以及胃肠道与腹膜腔紧密相连导致细菌经壁转移，因而易患这种感染。腹膜透析患者发生（）感染在两个方面存在问题：（1）由于透析患者免疫功能低下，感染可能是毁灭性的；（2）感染直接干扰他们的肾脏替代治疗。在本文中，我们介绍了一例由（）相关腹泻和结肠炎引起的腹膜透析（PD）相关性腹膜炎病例。在该患者中，腹膜炎是由肠道细菌经壁转移所致。虽然腹膜液培养未培养出该病原体（可能是因为之前经验性使用了广谱抗生素），但粪便分析的PCR阳性结果提示（）相关性腹膜炎，同时（）针对性治疗（甲硝唑）和停用广谱抗生素后临床症状迅速改善。该患者用甲硝唑成功治疗，未拔除PD导管。（）感染很常见，内科医生常常是此类患者的首诊医生。本文重点介绍了一名PD患者发生的（）感染，并提高了对透析患者中这种感染的认识。
