Nontuberculous mycobacteria infections of peritoneal dialysis patients: A multicenter study

Alon Bnaya*, Yonit Wiener-Well, Hila Soetendorp, Yael Einbinder, Yossi Paitan, Margarita Kunin, Tatiana Tanasiychuk, Daniel Kushnir, Etty Kruzel-Davila, Regina Gershkovitz, Roza Rosenberg, Aharon Bloch, Victoria Doviner, Marc V. Assous, Orly Peretz, Linda Shavit, Eli Ben-Chetrit

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Nontuberculous mycobacteria (NTM) infections pose a diagnostic challenge in peritoneal dialysis (PD) patients. In this study, we sought to identify findings that are suggestive of NTM infection in PD adult patients. Methods: All patients with NTM exit-site infection (ESI) with/without tunnel infection and peritonitis identified during the last decade in eight medical centers in Israel were included. Clinical, microbiological, and outcome data were collected and analyzed. Results: Thirty patients were identified; 16 had ESI (53%) and 14 had peritonitis (47%). Median age was 65 years (interquartile range 52–76). Abdominal pain and cloudy PD fluid were reported in all patients with peritonitis, whereas exit-site discharge and granulation tissue were common in patients with ESI. Fourteen patients (47%) had negative cultures prior NTM diagnosis, and isolation of diphtheroids or Corynebacterium spp. was reported in 9 of 30 patients (30%). Antimicrobial treatment prior to diagnosis was documented in 13 of 30 patients (43%). Delayed diagnosis was frequent. Treatment regimens and duration of therapy varied widely. In 26 of 30 (87%) patients, catheter was removed and 19 of 30 patients (63%) required permanent transition to hemodialysis. Two patients with peritonitis (2 of 14, 14%) and seven with ESI (7 of 16, 44%) were eligible for continuation of PD. Conclusions: Culture negative peritonitis, isolation of diphtheroids or Corynebacterium spp., previous exposure to antibiotics, and/or a refractory infection should all prompt consideration of PD-related NTM infection and timely workup. Catheter removal is recommended aside prolonged antimicrobial therapy. In select patients with ESI, continuation of PD may be feasible.

Original languageEnglish
Pages (from-to)284-291
Number of pages8
JournalPeritoneal Dialysis International
Volume41
Issue number3
DOIs
StatePublished - May 2021

Keywords

  • Exit-site infection
  • nontuberculous mycobacteria
  • peritonitis

Fingerprint

Dive into the research topics of 'Nontuberculous mycobacteria infections of peritoneal dialysis patients: A multicenter study'. Together they form a unique fingerprint.

Cite this