A rare case of successful treatment of peritoneal dialysis patient with Serratia marcescens peritonitis without catheter removal: case report and literature review

被引:1
作者
Xie, Ruizhi [1 ]
Ling, Ying [2 ]
Huang, Yaru [3 ]
Qin, Lulu [1 ]
Bao, Kun [1 ,4 ,5 ,6 ]
Qin, Xindong [1 ,4 ,5 ,6 ]
机构
[1] Guangzhou Univ Chinese Med, Clin Med Coll 2, Guangzhou, Peoples R China
[2] Guangzhou Univ Chinese Med, Shenzhen Hosp Futian, Clin Med Coll 6, Shenzhen, Guangdong, Peoples R China
[3] Guangzhou Univ Chinese Med, Coll Basic Med Sci, Guangzhou, Peoples R China
[4] Guangdong Prov Hosp Chinese Med, Nephrol Dept, Guangzhou, Peoples R China
[5] Guangzhou Univ Chinese Med, Affiliated Hosp 2, State Key Lab Dampness Syndrome Chinese Med, Guangzhou, Peoples R China
[6] Guangdong Prov Key Lab Chinese Med Prevent & Treat, Guangzhou, Peoples R China
来源
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY | 2024年 / 14卷
关键词
case report; Serratia marcescens; peritoneal dialysis; peritonitis; infection route; treatment; INTRAPERITONEAL MEROPENEM; HEMODIALYSIS; OUTBREAKS;
D O I
10.3389/fcimb.2024.1373036
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Serratia marcescens, as a Gram-negative opportunistic pathogen, is a rare cause of peritonitis and has worse clinical outcomes than Gram-positive peritonitis. In this case report, we describe a case of Serratia marcescens associated peritonitis that was successfully cured without catheter removal. A 40-year-old male patient with peritoneal dialysis who worked in the catering industry was admitted to the hospital for 16 hours after the discovery of cloudy peritoneal dialysate and abdominal pain. Ceftazidime and cefazolin sodium were immediately given intravenously as an empirical antibiotic regimen. After detecting Serratia marcescens in the peritoneal diasate culture, the treatment was switched to ceftazidime and levofloxacin. The routine examination of peritoneal dialysate showed a significant decrease in white blood cells, the peritoneal dialysate became clear, and the peritoneal dialysis catheter was retained. The patient was treated for 2 weeks and treated with oral antibiotics for 1 week. It is necessary to further strengthen the hygiene of work environment to prevent Serratia marcescens infection in peritoneal dialysis patients. We recommend that patients with Serratia marcescens associated peritonitis should be treated with a combination of antibiotics as early as possible empirically, and at the same time, the peritoneal dialysis fluid culture should be improved, and the antibiotic regimen should be timely adjusted according to the drug sensitivity results. For patients with clinical symptoms for more than 3 days, considering the strong virulence of Serratia marcescens, whether to use meropenem directly or not can provide a reference for clinical decision-making. Further clinical studies are needed to achieve more precise anti-infective treatment.
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页数:7
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