CAMPYLOBACTER PERITONITIS COMPLICATING PERITONEAL DIALYSIS: A REVIEW OF 12 CONSECUTIVE CASES

Background: Peritoneal dialysis-associated peritonitis secondary to Campylobacter organisms is uncommon. Few studies have assessed either treatment or clinical outcomes. Methods: We reviewed all Campylobacter peritonitis episodes occurring in a single dialysis unit from 1994 to 2011. Results: During the study period, 12 episodes of Campylobacter peritonitis (0.45% of all peritonitis episodes) were recorded. Diarrhea was uncommon (8.3%). The overall primary response rate was 91.7%; the complete cure rate was 75.0%. Among 6 patients who failed to respond to standard antibiotics by day 5, all improved after administration of an oral macrolide (erythromycin or clarithromycin). Of those 6 patients, 5 experienced a complete cure, and 1 patient experienced relapse of culture-negative peritonitis. No patient required Tenckhoff catheter removal or temporary hemodialysis support. The 30-day mortality was 0%. Conclusions: Campylobacter peritonitis might not respond to first-line conventional antibiotics, and an oral macrolide is recommended if Campylobacter is confirmed. The findings from our analysis do not support the use of fluoroquinolone, which is associated with a high resistance rate. Perit Dial Int 2013; 33(2):189-194 www.PDIConnect.com epub ahead of print: 02 Oct 2012 doi:10.3747/pdi.2011.00323