Relapsing Peritonitis Caused by Bordetella bronchiseptica in Continuous Ambulatory Peritoneal Dialysis Patient: A Case Report

Bordetella (B) bronchiseptica is a common veterinary pathogen, but has rarely been implicated in human infections. Most patients with B. bronchiseptica infections are compromised clinically such as in patients with a malignancy, AIDS, malnutrition, or chronic renal failure. We experienced a case of relapsing peritonitis caused by B. bronchiseptica associated with continuous ambulatory peritoneal dialysis (CAPD). A 56-yr-old male, treated with CAPD due to end stage renal disease (ESRD), was admitted with complaints of abdominal pain and a turbid peritoneal dialysate. The culture of peritoneal dialysate identified B. bronchiseptica. The patient was treated with a combination of intraperitoneal antibiotics. There were two further episodes of relapsing peritonitis, although the organism was sensitive to the used antibiotics. Finally, the indwelling CAPD catheter was removed and the patient was started on hemodialysis. This is the first report of a B. bronchiseptica human infection in the Korean literature.

The Preventive Effects of Practical Training on the Spot for Peritoneal Dialysis Related Peritonitis in Continuous Ambulatory Peritoneal Dialysis Patients / 대한신장학회지

PURPOSE: Peritoneal dialysis related peritonitis remains one of the most common causes of hospitalization and discontinuation of peritoneal dialysis. Patient education and the individual environment play a significant role in improving the clinical outcomes. Therefore, this study focused on the preventive effects of practical training on the spot for peritoneal dialysis related peritonitis in continous ambulatory peritoneal dialysis (CAPD) patients. METHODS: Fifty-eight patients who were started on CAPD were as the primary intended treatment modality. The patients were given to a questionnaire regarding their gender, age, place of residence, level of education, economic status, sterile technique, knowledge of personal hygiene, placing a correct region for exchanging a fluid bag, and their duration of CAPD. During a home visit, the patients were instructed in how to sterilize the region of dialysis and maintain sterility in dialysis. RESULTS: Seventy four cases of peritonitis from 35 patients were identified over the 2 year's period. In the rural residences where there is a lower socio-economic status, the rates of peritonitis decreased in those patients who had received training on the spot within 6 months from the start of peritoneal dialysis compared with the patients after the 6 month period. Lower rates of peritonitis were noted in the patients who received training earlier (r=0.19, p=0.03). CONCLUSION: Ongoing and repetitive individualized education is needed to prevent peritoneal dialysis related peritonitis. The incidence of peritoneal dialysis related peritonitis can be reduced by educating these patients individually.