Peritoneal dialysis-associated peritonitis caused by Mycobacteroides massiliense: the first case and review of the literature.


Journal

BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793

Informations de publication

Date de publication:
12 03 2021
Historique:
received: 19 11 2020
accepted: 08 03 2021
entrez: 13 3 2021
pubmed: 14 3 2021
medline: 15 12 2021
Statut: epublish

Résumé

Peritoneal dialysis (PD)-associated peritonitis caused by nontuberculous Mycobacterium is rare; however, the number of cases has increased over the past decades. Mycobacteroides massiliense is a subspecies of the Mycobacteroides abscessus complex. It has different clinical characteristics compared to the other subspecies of the complex. Previous case reports of PD-associated peritonitis caused by Mycobacteroides abscessus complex have not distinguished the subspecies in detail. A 40-year-old man presented with an exit-site and tunnel infection refractory to antibiotic therapy. Peritonitis occurred after simultaneous catheter removal and reinsertion. The Mycobacteroides abscessus complex was detected in the culture of the dialysis effluent. Removal of the PD catheter combined with antibiotics, including macrolides, resulted in a good clinical course. Further analysis of multiplex PCR and the hsp65 gene sequence identified the bacterium as Mycobacteroides massiliense. The Mycobacteroides abscessus complex is classified into three subspecies; Mycobacteroides abscessus, Mycobacteroides massiliense, and Mycobacteroides bolletii. These have different characteristics, particularly antibiotic susceptibility. Therefore, clear identification of the subspecies of the Mycobacteroides abscessus complex is necessary for definitive treatment.

Sections du résumé

BACKGROUND
Peritoneal dialysis (PD)-associated peritonitis caused by nontuberculous Mycobacterium is rare; however, the number of cases has increased over the past decades. Mycobacteroides massiliense is a subspecies of the Mycobacteroides abscessus complex. It has different clinical characteristics compared to the other subspecies of the complex. Previous case reports of PD-associated peritonitis caused by Mycobacteroides abscessus complex have not distinguished the subspecies in detail.
CASE PRESENTATION
A 40-year-old man presented with an exit-site and tunnel infection refractory to antibiotic therapy. Peritonitis occurred after simultaneous catheter removal and reinsertion. The Mycobacteroides abscessus complex was detected in the culture of the dialysis effluent. Removal of the PD catheter combined with antibiotics, including macrolides, resulted in a good clinical course. Further analysis of multiplex PCR and the hsp65 gene sequence identified the bacterium as Mycobacteroides massiliense.
CONCLUSIONS
The Mycobacteroides abscessus complex is classified into three subspecies; Mycobacteroides abscessus, Mycobacteroides massiliense, and Mycobacteroides bolletii. These have different characteristics, particularly antibiotic susceptibility. Therefore, clear identification of the subspecies of the Mycobacteroides abscessus complex is necessary for definitive treatment.

Identifiants

pubmed: 33711948
doi: 10.1186/s12882-021-02297-y
pii: 10.1186/s12882-021-02297-y
pmc: PMC7953774
doi:

Types de publication

Case Reports Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

90

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Auteurs

Shintaro Hamada (S)

Division of Gastroenterology and Nephrology, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.

Tomoaki Takata (T)

Division of Gastroenterology and Nephrology, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan. t-takata@tottori-u.ac.jp.

Tsuyoshi Kitaura (T)

Division of Infectious Diseases, Tottori University Faculty of Medicine, Yonago, Tottori, 683-8504, Japan.

Chiori Teraoka (C)

Department of Clinical Laboratory, Tottori University Hospital, Yonago, Tottori, 683-8504, Japan.

Akio Aono (A)

The Research Institute of Tuberculosis, Japan Anti-tuberculosis Association, Kiyose, Tokyo, 204-0023, Japan.

Sosuke Taniguchi (S)

Division of Gastroenterology and Nephrology, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.

Yukari Mae (Y)

Division of Gastroenterology and Nephrology, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.

Hajime Isomoto (H)

Division of Gastroenterology and Nephrology, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.

Hiroki Chikumi (H)

Division of Infectious Diseases, Tottori University Faculty of Medicine, Yonago, Tottori, 683-8504, Japan.

Satoshi Mitarai (S)

The Research Institute of Tuberculosis, Japan Anti-tuberculosis Association, Kiyose, Tokyo, 204-0023, Japan.

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