A Case of Delftia acidovorans Peritonitis in a Peritoneal Dialysis Patient Managed with Preserving the Dialysis Catheter / 대한신장학회지

ABSTRACT

Delftia acidovarans is aerobic, nonfermentative Gram-negative rod commonly found in soil and water. Generally it is nonpathogenic but it unusually can cause bacteremia in immunocompromised patients. We present a case of peritonitis due to D. acidovorans in a patient on continuous ambulatory peritoneal dialysis. A 75-year-old woman was admitted with abdominal pain and cloudy peritoneal effluent. She was empirically treated with intraperitoneal (IP) cefazolin and ceftazidime, and then IP ceftazidime and oral ciprofloxacin, but peritonitis did not improve. Seven days after admission, D. acidovorans was identified from the peritoneal effluent, which was sensitive to amikacin, ceftazidime, ciprofloxacin and imipenem. Catheter removal was considered with regard to poor response to adequate antibiotics; however, 4 days after changing to IP imipenem/cilastatin, abdominal pain, the leukocyte count of peritoneal effluent and C-reactive protein decreased. She was treated with imipenem/cilastatin for two weeks and discharged with the dialysis catheter intact.