Resistant yersinia enterocolitica peritonitis in a peritoneal dialysis patient

Abstract

Peritonitis is an important problem of peritoneal dialysis patients. Although Gram (+) bacteria are more frequent, Gram (-) bacteria can rarely be the cause of peritonitis.Yersinia enterocolitica is a Gram (-) enteric bacteria that especially causes gastrointestinal infections via contaminated food intake in immunosuppressive situations such as haemochromatosis, desferroxamine therapy or chronic hepatitis. We report a 51-year-old man who had been undergoing SAPD because of chronic renal failure for 2 years. We evaluated his peritoneal fl uid because of symptoms of peritonitis. His peritoneal cellular composition was consistent with peritonitis and after the microbiological culture of the fl uid we determined Yersinia enterocolitica as the pathogenic agent. The peritonitis persisted despite the administration of long term combined antibiotherapy and we removed the peritoneal catheter. In conclusion, Yersinia enterocolitica peritonitis is resistant to conventional antibiotic therapy and an indication for catheter removal.

Özet

Peritonit, son dönem böbrek yetmezliği nedeniyle periton diyalizi uygulayan hastalarda önemli sorunlardan biridir. Peritonitler, sıklıkla Gram (+) bakterilerden kaynaklansa da Gram (-) bakteriler de etken olabilmektedir.Yersinia enterocolitica, insanlara genellikle kontamine gıdalarla bulaşan, daha çok gastrointestinal tutulumla seyreden enfeksiyon tablolarına neden olan ve genellikle hemokromatozis, desferoksamin tedavisi, kronik hepatik hastalık ya da öteki immünsüpresif durumlarda görülen Gram (-) bir enterik bakteridir. Yersinia enterocolitica erişkin SAPD ilişkili peritonitlerin nadir bir etkenidir.