Department of Nephrology, National Hospital Organization Kyoto Medical Center, 1-1, Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan.
CEN Case Rep. 2023 Feb;12(1):68-72. doi: 10.1007/s13730-022-00718-x. Epub 2022 Jul 25.
A 57-year-old Japanese man on peritoneal dialysis developed peritoneal dialysis-associated peritonitis caused by Rhodococcus corynebacterioides. After the introduction of peritoneal dialysis, he had experienced four episodes of peritonitis, but the causative organism was not identified in any of episode. When he was hospitalized for the fifth episode of peritonitis, Rhodococcus corynebacterioides was detected in the ascitic fluid. He improved after an intraperitoneal administration of vancomycin (VCM) that was used based on the treatment of peritonitis caused by Corynebacterium spp. However, he then had repeated flare-ups and eventually required the removal of the peritoneal dialysis catheter due to recurrent peritonitis. 16S rRNA gene sequencing is generally needed to positively identify Rhodococcus corynebacterioides. In this case, we were able to rapidly identify the organism by using mass spectrometry and then apply this knowledge to the patient's treatment. To the best of our knowledge, this is the first reported case of peritoneal dialysis-associated peritonitis caused by Rhodococcus corynebacterioides.
一位 57 岁的日本男性腹膜透析患者发生了由棒状杆菌属红色糖菌引起的腹膜透析相关性腹膜炎。在开始腹膜透析后，他已经经历了四次腹膜炎发作，但在任何一次发作中都未确定病原体。当他因第五次腹膜炎发作住院时，在腹水检测到了棒状杆菌属红色糖菌。在腹腔内给予万古霉素（VCM）治疗后，他的病情得到了改善，该治疗方案是基于对棒状杆菌属引起的腹膜炎的治疗方法。然而，他随后出现了反复发作，并最终因反复发生腹膜炎而需要移除腹膜透析导管。一般需要通过 16S rRNA 基因测序来阳性鉴定棒状杆菌属红色糖菌。在这种情况下，我们能够通过使用质谱法快速鉴定该病原体，然后将这一知识应用于患者的治疗中。据我们所知，这是首例由棒状杆菌属红色糖菌引起的腹膜透析相关性腹膜炎的报告病例。
