| Autor: |
Yap, Desmond Y.H., Chan, Jasper F.W., Yip, Terence, Mok, Maggie M.Y., Kwan, Lorraine P.Y., Lo, Wai Kei, Chan, Tak Mao |
| Zdroj: |
Peritoneal Dialysis International; July 2016, Vol. 36 Issue: 4 p390-394, 5p |
| Abstrakt: |
Background Burkholderia cepaciais a hardy bacterium with intrinsic resistance to multiple antibiotics and high transmissibility. Opportunistic healthcare-associated B. cepaciainfections among immunocompromised or critically ill patients have been reported, but there is limited data on the clinical characteristics and treatment outcomes of exit-site infection (ESI) in peritoneal dialysis (PD) patients.Patients and methods Patients who suffered from B. cepaciaESI from 1 January 2004 to 31 December 2014 were reviewed. The clinical characteristics and treatment outcomes of the patients and the antibiotic susceptibility patterns of the bacterial isolates were analyzed.Results Twenty-two patients were included for analysis. Eight patients (36.4%) had medical conditions which impaired host immunity, while 7 (31.8%) had pre-existing skin abnormalities. Three patients (13.6%) progressed to tunnel-tract infection and another 3 patients (13.6%) developed associated peritonitis. Fifteen patients (68.2%) responded to medical treatment while 7 (31.8%) required catheter removal. Eleven patients (50.0%) had recurrent B. cepaciaESI, which occurred at 7.8 months (95% confidence interval [CI] 0.1 – 19.4 months) after the first episode. Most B. cepaciastrains were susceptible to ceftazidime (95.5%), piperacillin/tazobactam (95.5%), and piperacillin (90.9%). Besides aminoglycosides (80 – 100%), high rates of resistance were also observed for ticarcillin/clavulanate (90.9%).Conclusion Burkholderia cepaciaESI is associated with low rates of tunnel-tract infection or peritonitis, but the risk of recurrence is high. Most cases can be managed with medical treatment alone, although one third of patients might require catheter removal. |
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