患者在腹膜透析（PD）中发生乌山不动杆菌性腹膜炎：病例报告及文献复习。
Acinetobacter ursingii peritonitis in a patient on peritoneal dialysis (PD): case report and literature review.
机构信息
Nephrology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Ctra Colmenar Viejo km 9.1, Madrid, 28034, Spain.
Universidad de Alcalá de Henares, UAH, Madrid, Spain.
出版信息
BMC Nephrol. 2024 Nov 30;25(1):439. doi: 10.1186/s12882-024-03881-8.
BACKGROUND
Peritonitis is a frequent complication of PD that can lead to technique discontinuation and increase morbidity and mortality. It is caused mainly by gram-positive bacteria (up to 70%); however, gram-negative organisms usually have relatively poor outcomes. Among gram-negative bacteria, Acinetobacter is rare, especially Acinetobacter ursingii.
CASE REPORT
We report the third case of PD peritonitis caused by Acinetobacter ursingii, treated with directed intraperitoneal antibiotics with good clinical response and favorable outcome.
CONCLUSION
Although Acinetobacter ursingii is rare, it is potentially harmful because of its challenging identification and antibiotic resistance with therapeutic consequences, requiring at least two antibiotics and careful follow up. Keeping in mind that it is ubiquitous, careful technique, training/retraining seems highly recommended.
背景
腹膜炎是 PD 的常见并发症，可导致技术中断并增加发病率和死亡率。它主要由革兰氏阳性菌（高达 70%）引起；然而，革兰氏阴性菌通常预后较差。在革兰氏阴性菌中，不动杆菌很少见，尤其是鲍曼不动杆菌。
病例报告
我们报告了第三例由鲍曼不动杆菌引起的 PD 腹膜炎，采用定向腹腔内抗生素治疗，临床反应良好，结果良好。
结论
尽管鲍曼不动杆菌很少见，但由于其鉴定具有挑战性且具有抗生素耐药性，可能具有危害性，这会对治疗产生影响，需要至少使用两种抗生素并仔细随访。考虑到它无处不在，我们强烈建议保持谨慎的技术，加强培训/再培训。
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