Department of Nephrology and Hypertension, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Glickman Urological & Kidney Institute, Cleveland Clinic, OH, USA.
J Vasc Access. 2022 Nov;23(6):966-968. doi: 10.1177/11297298211015083. Epub 2021 May 13.
Peritoneal dialysis associated infections are common and associated with high morbidity and mortality, if not treated in a timely manner. is an uncommon pathogen in peritoneal dialysis associated infections, but is resistant to standard antimicrobial therapies used. Here we present a case of a 56 year-old male with end stage kidney disease on peritoneal dialysis for 7 years who developed a exit-site infection. Peritonitis and peritoneal dialysis catheter tunneled line infections were ruled out and he was treated with linezolid, amikacin, and azithromycin. He required peritoneal dialysis catheter removal and hemodialysis conversion. Antibiotics were de-escalated based on inducibility and antibiotic sensitivities. Linezolid and amikacin were continued for approximately 7 total weeks, with complete resolution of the infection. Further research is needed to refine challenges in the management of exit-site infections, including risk factors for development of , optimal selection of empiric antibiotic therapies, duration of antibiotics, and peritoneal dialysis catheter re-insertion timing.
与腹膜透析相关的感染很常见，如果不及时治疗，会导致高发病率和死亡率。 是腹膜透析相关感染中一种不常见的病原体，但对标准的抗菌治疗药物具有耐药性。在这里，我们报告了一例 56 岁男性患者的病例，该患者患有终末期肾病，已接受腹膜透析治疗 7 年，出现出口部位感染。排除了腹膜炎和腹膜透析导管隧道感染，并使用利奈唑胺、阿米卡星和阿奇霉素进行治疗。他需要移除腹膜透析导管并转为血液透析。根据可诱导性和抗生素敏感性，逐渐减少抗生素的使用。利奈唑胺和阿米卡星总共使用了大约 7 周，感染完全得到解决。需要进一步研究以解决 出口部位感染管理方面的挑战，包括 的发病风险因素、经验性抗生素治疗方案的最佳选择、抗生素使用时间以及腹膜透析导管重新插入的时机。
