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KMID : 0359920100290050675
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Korean Journal of Nephrology
2010 Volume.29 No. 5 p.675 ~ p.678
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A Case of Peritoneal Dialysis Peritonitis Due to Methicillin-Resistant Staphylococcus auricularis
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Choi Jong-Wook
Kim Bae-Keun
Hwang Kyu-Sig
Park Joon-Sung
Lee Chang-Hwa
Kang Chong-Myung
Kim Gheun-Ho
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Abstract
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Although coagulase-negative staphyloccus is the most common organism causing peritonitis in peritoneal dialysis (PD) patients, only one case of PD peritonitis due to Staphylococcus auricularis, the normal flora of external auditory meatus, has been reported over the world. Here we add a case of PD peritonitis caused by methicillin-resistant Staphylococcus auricularis, which was successfully treated with vancomycin. A 79-year-old male PD patient was admitted because of abdominal pain and cloudy peritoneal fluid. At admission, the exit site was clear, and no rebound tenderness was noted although the abdominal wall was diffusely tender. Gram stain of the peritoneal fluid did not reveal any organism, but white blood cell count was 1,210/mm3, with 80% polymorphonuclear cells and 10% lymphocytes. Empirical antibiotic therapy was started with intraperitoneal cefazolin and ceftazidime. Over the next few days, however, the peritoneal fluid was still turbid and showed an elevated cell count. Then, the result of peritoneal fluid culture identified that the organism was oxacillin-resistant Staphylococcus auricularis. Thus the antibiotics were switched into vancomycin, and intraperitoneal vancomycin 1 gm was administered three times at 5 days’ intervals to achieve completely clear peritoneal fluid. Staphylococcus auricularis should be considered as a new potential skin organism causing PD peritonitis.
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KEYWORD
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Staphylococcus, Peritoneal dialysis, Peritonitis
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