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Serratia marcescens as a cause of peritonitis in peritoneal dialysis

Authors: Nabil Hmaidouch; Qods Yacoubi; Naima Ouzeddoun; Loubna Benamar;

Serratia marcescens as a cause of peritonitis in peritoneal dialysis

Abstract

Introduction: Peritoneal dialysis (PD) is increasingly used as a replacement method in end-stage chronic renal disease (ESRD), mainly due to its autonomy and quality of life benefits. However, peritonitis in PD, particularly Serratia marcescens peritonitis, can be a serious complication requiring catheter removal. Clinical case: We present the case of a 17-year-old adolescent who presented three episodes of peritonitis in PD characterized by dialysate fluid turbidity, abdominal pain, and vomiting without diarrhea in less than six months. Diagnostic workshop: The peritoneal fluid had a leukocyte count between 4,370 and 16,000 u/ul in each admission. The culture of the peritoneal fluid reported Serratia Marcescens in all three episodes. Treatment: For three weeks, empirical antibiotic treatment was with intraperitoneal ceftazidime (1 g/day, adjusted for antibiogram). After the last episode, the PD catheter was removed, and a second catheter was placed on the contralateral side. Outcome: Four days after catheter insertion, DPA was gradually restarted at low volume. After one year, the patient was free of peritonitis. Conclusions: Serratia marcescens is a gram-negative bacterium primarily responsible for recurrent peritonitis with a poor prognosis. Peritonitis caused by Serratia marcescens, like other Enterobacteriaceae, requires vigilant antibiotic management. Treatment tailored to the recommendations, despite in vitro sensitivity to third-generation cephalosporins, may improve the survival of the technique while preserving the catheter.

Keywords

Medicine (General), R5-920, Peritoneal dialysis, Catheter removal, Serratia Marcescens, RC870-923, Peritonitis, Internal medicine, RC31-1245, Diseases of the genitourinary system. Urology

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold