복막투석 환자에서 녹농균에 의한 복막염

Abstract

Peritonitis is one of the major complications leading to mortality and technical failure in patients undergoing peritoneal dialysis (PD). Especially, peritonitis due to Pseudomonas species is associated with poor response to conventional antibiotics and with high rates of catheter removal. We have examined the incidence, clinical course of Pseudomonas peritonitis. Between January 2001 and December 2008, episodes of peritonitis due to Pseudomonas species in Keimyung University Dongsan Hospital were reviewed retrospectively. In 820 episodes of peritonitis occurred during the studied period, a total of 28 episodes of Pseudomonas peritonitis occurred in 26 PD patients. The mean age of the Pseudomonas peritonitis patients was 57.6±9.9 years, and male:female ratio was 7:19. The mean occurrence period from the beginning of PD was 16.3±14.6 months. The organisms isolated were P. aeruginosa, P. oryzihabitans, P. fluorescens, P. mendocina, P. stutzeri and P. putida. Peritonitis was cured in 20 cases with the administration of antibiotics. However, catheters had to be removed in 6 cases. Pseudomonas peritonitis is associated with high rates of catheter removal. When Pseudomonas peritonitis is not improved despite of antibiotic treatment, early peritoneal catheter removal must be considered to prevent further injuries of peritoneum and patient death.