Peritoneal Dialysis-Related Peritonitis with Acinetobacter baumannii: A Review of Seven Cases

Acinetobacter baumannii, a gram-negative bacterium, has been identified as a significant cause of antibiotic-resistant infections and has emerged as one of the most troublesome pathogens for health care institutions (1). Multidrug resistant (MDR) A. baumannii is a growing problem worldwide, and reports of carbapenem-resistant A. baumannii strains are common. Some A. baumannii strains have been found to be resistant to all known antibiotics (2). Although MDR A. baumannii is rarely reported in association with peritonitis in peritoneal dialysis (PD) patients, when this organism is present, it results in serious infection and increases the possibility of dropout or mortality (3-5). Here, we present 7 cases of peritonitis caused by A. baumannii. Of those cases, 2 involved MDR A. baumannii, and 1 was caused by a carbapenem-resistant strain. Refractory peritonitis in 3 patients resulted in prolonged hospitalization, the need for catheter removal, and finally PD dropout and a switch to hemodialysis. The other 4 patients were cured and continued PD therapy. Acinetobacter peritonitis and its treatment process are particularly concerning.