Non-tuberculous mycobacterial PD peritonitis in Australia
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Peritonitis can be a severe complication of peritoneal dialysis (PD) due to associated morbidity and mortality. Non-tuberculous mycobacteria (NTM) are a rare cause of PD peritonitis, with high rates of catheter removal and conversion to haemodialysis, and a reported mortality as high as 40 %. The incidence, culprit NTM species, and outcomes associated with PD peritonitis have not been described in many countries, including Australia.
We examined the Australia and New Zealand Dialysis and Transplant Registry from 1 October 2003 to 31 December 2009 for all prevalent peritoneal dialysis patients. Patient characteristics, organisms, treatment and outcome for all NTM PD peritonitis episodes were obtained.
Twelve cases of NTM PD peritonitis were reported, including the first reports of infection due to Mycobacterium hassiacum and Mycobacterium neoaurum. The incidence of NTM PD peritonitis was approximately 1 per 1000 PD patient-years. Recovery occurred in 11 patients, including 3 without removal of their Tenckhoff catheters. A range of antibiotics were utilised. One patient died of sclerosing peritonitis 5 months after diagnosis of PD peritonitis.
Non-tuberculous mycobacteria PD peritonitis is a rare cause of peritonitis, and mortality may be lower than previously reported. Catheter removal occurred in the majority of patients, and adverse outcomes were not observed for those in whom it was retained.
KeywordsIncidence Mortality Mycobacterium Peritoneal dialysis Peritonitis Treatment
Medical and nursing staff from Australian Renal units for their contributions to the database.
Conflict of interest
The authors declare that they have not conflicts of interest.
- 1.Brown F, Gulyani A, Dent H et al (2011) Chapter 6. Peritoneal dialysis. In: ANZDATA Registry 2011 Report: http://www.anzdata.org.au/v1/report_2011.html
- 12.Jiang SH, Roberts DM, Dawson AH, Jardine M (2012) Mycobacterium fortuitum as a cause of peritoneal dialysis-associated peritonitis: case report and review of the literature. BMC Nephrol 13:35. doi: 10.1186/1471-2369-13-35
- 14.The CARI guidelines—Treatment of peritoneal dialysis-associated peritonitis in adults (2004). http://www.cari.org.au/guidelines.php