XANTHOMONAS-MALTOPHILIA PERITONITIS IN UREMIC PATIENTS RECEIVING CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

Xanthomonas maltophilia peritonitis has been only occasionally reporte d in patients receiving continuous ambulatory peritoneal dialysis, We present a series of six cases of peritonitis caused by such bacteria, accounting for 1.5% of all peritonitis episodes encountered in our ren al unit over the past 5 years, Recent bacterial peritonitis treated wi th broad-spectrum antibiotics was the major risk factor, and the outco me was poor with medical treatment alone, Secondary peritonitis, espec ially fungal, was common and probably related to the prolonged course of antibiotics, All patients eventually required removal of the cathet er, either because the effluent failed to clear up or because of secon dary peritonitis. We suggest that X maltophilia peritonitis be treated with double antibiotics as soon as it is diagnosed, To prevent the de velopment of superimposed infection after prolonged administration of antibiotics, the Tenckhoff catheter should be removed if the peritonit is fails to respond to a short course of antibiotics. (C) 1997 by the National Kidney Foundation, Inc.