The Role of Non-Tuberculous Mycobacteria in Peritoneal Dialysis-Related Infections

A Literature Review

Naoki Washida, Hiroshi Itoh

Research output: Contribution to journalArticle

Abstract

Background: Peritonitis is one of the most frequent reasons for withdrawal of peritoneal dialysis (PD). Although most cases of PD-related peritonitis can be treated with antibiotics, it is occasionally refractory and culture-negative. Summary: The causes of refractory PD-related peritonitis include antibiotic-resistant bacteria, fungal peritonitis, biofilm formation in PD catheters, bacterial translocation from the gastrointestinal tract, and encapsulating peritoneal sclerosis. Among them, culture-negative peritonitis is notable, and non-tuberculous mycobacteria (NTM) can be a cause of culture-negative peritonitis. In the present study, the treatment and outcomes of NTM peritonitis and exit site infections were investigated by collecting data from relevant reviews published during the last 10 years. Catheter removal was required in 92.2% of the patients with NTM peritonitis, and withdrawal of PD was performed in 91.9%. The overall mortality rate (including unrelated deaths) was 12.4% in patients with NTM peritonitis. Among patients with NTM exit site infections, 33.3% developed peritonitis, and catheter removal was required in 50.0%. A lower percentage of patients stopped PD when the catheter was removed without developing peritonitis (37.5%) than when it was removed after the onset of peritonitis (91.9%). Changing the exit site or unroofing was performed in 12.5% of the patients with NTM exit site infections. In addition, these infections resolved with antibiotics alone or without antibiotics in 18.8 and 12.5% of the patients, respectively, while 6.25% of the patients died.

Original languageEnglish
Pages (from-to)155-161
Number of pages7
JournalContributions to Nephrology
Volume196
DOIs
Publication statusPublished - 2018 Jan 1

Fingerprint

Peritoneal Dialysis
Mycobacterium
Peritonitis
Infection
Catheters
Anti-Bacterial Agents
Peritoneal Fibrosis
Bacterial Translocation
Biofilms
Gastrointestinal Tract
Bacteria

ASJC Scopus subject areas

  • Nephrology

Cite this

The Role of Non-Tuberculous Mycobacteria in Peritoneal Dialysis-Related Infections : A Literature Review. / Washida, Naoki; Itoh, Hiroshi.

In: Contributions to Nephrology, Vol. 196, 01.01.2018, p. 155-161.

Research output: Contribution to journalArticle

@article{cc0eac39d6fa432f986dd5f27c06a82b,
title = "The Role of Non-Tuberculous Mycobacteria in Peritoneal Dialysis-Related Infections: A Literature Review",
abstract = "Background: Peritonitis is one of the most frequent reasons for withdrawal of peritoneal dialysis (PD). Although most cases of PD-related peritonitis can be treated with antibiotics, it is occasionally refractory and culture-negative. Summary: The causes of refractory PD-related peritonitis include antibiotic-resistant bacteria, fungal peritonitis, biofilm formation in PD catheters, bacterial translocation from the gastrointestinal tract, and encapsulating peritoneal sclerosis. Among them, culture-negative peritonitis is notable, and non-tuberculous mycobacteria (NTM) can be a cause of culture-negative peritonitis. In the present study, the treatment and outcomes of NTM peritonitis and exit site infections were investigated by collecting data from relevant reviews published during the last 10 years. Catheter removal was required in 92.2{\%} of the patients with NTM peritonitis, and withdrawal of PD was performed in 91.9{\%}. The overall mortality rate (including unrelated deaths) was 12.4{\%} in patients with NTM peritonitis. Among patients with NTM exit site infections, 33.3{\%} developed peritonitis, and catheter removal was required in 50.0{\%}. A lower percentage of patients stopped PD when the catheter was removed without developing peritonitis (37.5{\%}) than when it was removed after the onset of peritonitis (91.9{\%}). Changing the exit site or unroofing was performed in 12.5{\%} of the patients with NTM exit site infections. In addition, these infections resolved with antibiotics alone or without antibiotics in 18.8 and 12.5{\%} of the patients, respectively, while 6.25{\%} of the patients died.",
author = "Naoki Washida and Hiroshi Itoh",
year = "2018",
month = "1",
day = "1",
doi = "10.1159/000485716",
language = "English",
volume = "196",
pages = "155--161",
journal = "Contributions to Nephrology",
issn = "0302-5144",
publisher = "S. Karger AG",

}

TY - JOUR

T1 - The Role of Non-Tuberculous Mycobacteria in Peritoneal Dialysis-Related Infections

T2 - A Literature Review

AU - Washida, Naoki

AU - Itoh, Hiroshi

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Peritonitis is one of the most frequent reasons for withdrawal of peritoneal dialysis (PD). Although most cases of PD-related peritonitis can be treated with antibiotics, it is occasionally refractory and culture-negative. Summary: The causes of refractory PD-related peritonitis include antibiotic-resistant bacteria, fungal peritonitis, biofilm formation in PD catheters, bacterial translocation from the gastrointestinal tract, and encapsulating peritoneal sclerosis. Among them, culture-negative peritonitis is notable, and non-tuberculous mycobacteria (NTM) can be a cause of culture-negative peritonitis. In the present study, the treatment and outcomes of NTM peritonitis and exit site infections were investigated by collecting data from relevant reviews published during the last 10 years. Catheter removal was required in 92.2% of the patients with NTM peritonitis, and withdrawal of PD was performed in 91.9%. The overall mortality rate (including unrelated deaths) was 12.4% in patients with NTM peritonitis. Among patients with NTM exit site infections, 33.3% developed peritonitis, and catheter removal was required in 50.0%. A lower percentage of patients stopped PD when the catheter was removed without developing peritonitis (37.5%) than when it was removed after the onset of peritonitis (91.9%). Changing the exit site or unroofing was performed in 12.5% of the patients with NTM exit site infections. In addition, these infections resolved with antibiotics alone or without antibiotics in 18.8 and 12.5% of the patients, respectively, while 6.25% of the patients died.

AB - Background: Peritonitis is one of the most frequent reasons for withdrawal of peritoneal dialysis (PD). Although most cases of PD-related peritonitis can be treated with antibiotics, it is occasionally refractory and culture-negative. Summary: The causes of refractory PD-related peritonitis include antibiotic-resistant bacteria, fungal peritonitis, biofilm formation in PD catheters, bacterial translocation from the gastrointestinal tract, and encapsulating peritoneal sclerosis. Among them, culture-negative peritonitis is notable, and non-tuberculous mycobacteria (NTM) can be a cause of culture-negative peritonitis. In the present study, the treatment and outcomes of NTM peritonitis and exit site infections were investigated by collecting data from relevant reviews published during the last 10 years. Catheter removal was required in 92.2% of the patients with NTM peritonitis, and withdrawal of PD was performed in 91.9%. The overall mortality rate (including unrelated deaths) was 12.4% in patients with NTM peritonitis. Among patients with NTM exit site infections, 33.3% developed peritonitis, and catheter removal was required in 50.0%. A lower percentage of patients stopped PD when the catheter was removed without developing peritonitis (37.5%) than when it was removed after the onset of peritonitis (91.9%). Changing the exit site or unroofing was performed in 12.5% of the patients with NTM exit site infections. In addition, these infections resolved with antibiotics alone or without antibiotics in 18.8 and 12.5% of the patients, respectively, while 6.25% of the patients died.

UR - http://www.scopus.com/inward/record.url?scp=85051069788&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85051069788&partnerID=8YFLogxK

U2 - 10.1159/000485716

DO - 10.1159/000485716

M3 - Article

VL - 196

SP - 155

EP - 161

JO - Contributions to Nephrology

JF - Contributions to Nephrology

SN - 0302-5144

ER -