An experience with colistin applied in treatment of imunocompromised patients with peritonitis on peritoneal dialysis
2015
Introduction. Immunocompromised patients, such as those with multiple myeloma
on peritoneal dialysis, are particularly susceptible to the occurrence of
peritonitis. Case report. We presented a 56-year-old female patient with a
10-year history of multiple myeloma. The patient was on peritoneal dialysis
since 2010. During 2012 the patient had the first episode of peritonitis
that was successfully managed, but in 2013 the second episode of peritonitis
occured. Analysis of dialysate culture and exit site swab revealed the
presence of multiresistant Acinetobacter spp., which was susceptible only to
colistin. Prompt colistin therapy was administered at the doses of 100,000
units/day during six days, which resulted in complete recovery of the
patient, as well as improvement of local abdominal findings. Gram-negative
bacteria (genus Acinetobacter) are common causative agents in
hospital-acquired infections. Studies confirmed susceptibility of
Acinetobacter to colistin, which was also the case with the presented
patient. Intravenous administration of colistin resulted in a complete
remission of this severe, life-threatening peritonitis. Conclusion. Patients
with multiple myeloma and renal failure are highly prone to severe
life-threatening infections.
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