Bouery Céline, Azeroual Latifa, Hufnagel Gilles, Vrtovsnik François, Goffin Éric
Département de néphrologie, CHU Bichat-Claude Bernard, 75000 Paris, France; Département de néphrologie, Hôpital Saint-Georges Ajaltoum, Beyrouth, Liban; Département de néphrologie, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Institut Recherche Expérimentale et Clinique, avenue Hippocrate 10, 1200 Bruxelles, Belgique.
Département de néphrologie, CHU Bichat-Claude Bernard, 75000 Paris, France.
Nephrol Ther. 2021 Apr;17(2):128-131. doi: 10.1016/j.nephro.2020.09.008. Epub 2021 Jan 8.
The presence of a biofilm within the peritoneal dialysis catheter where bacteria are encapsulated, protected from the action of antibiotics and insidiously liberated within the dialysate, best explains the relapse of the infectious peritonitis, when antibiotics are withdrawn. We here report a serie of four clinical cases in whom the administration of urokinase within the peritoneal catheter in addition to the current antibiotherapy, has cured relapsing peritonitis due to Staphylococcus epidermidis in two cases, Acinetobacterjohnsonii in one case and Staphylococcus haemolyticus in one case, respectively. This approach, safe and easy, allowed the infection eradication and did prevent a catheter removal and a potential transfer of the patients to hemodialysis.
腹膜透析导管内存在生物膜，细菌被包裹在其中，免受抗生素作用，并在透析液中隐匿释放，这最能解释在停用抗生素时感染性腹膜炎为何会复发。我们在此报告一系列4例临床病例，在这些病例中，除了目前的抗菌治疗外，在腹膜导管内注射尿激酶，分别治愈了2例由表皮葡萄球菌、1例由约翰逊不动杆菌和1例由溶血葡萄球菌引起的复发性腹膜炎。这种方法安全简便，能够根除感染，避免了拔除导管以及患者可能转而接受血液透析的情况。
