Under-Recognized Pathogens in Peritoneal Dialysis Associated-Peritonitis: The Importance of Early Detection

Abstract

Peritoneal dialysis-associated-peritonitis remains a major concern, increasing patient morbidity and mortality. Empirical antibiotics should be quickly started to allow a rapid resolution of symptoms and preservation of the peritoneal membrane.We report a case of peritoneal dialysis-associated-peritonitis due to Prevotella salivae and Corynebacterium jeikeium, in a 51-year-old male. Suspected peritonitis led to an immediate prescription of vancomycin and ceftazidime, with no clinical improvement. Prevotella is difficult to identify in culture since it's a gramnegative anaerobic bacterium, so metronidazole administration was delayed over days.New diagnostic techniques have been explored for the early diagnosis of peritonitis, including polymerase chain reaction (PCR) for bacterial DNA fragments. A multiplex PCR panel that includes Prevotella, already available for other applications, could be an advantage in cases like this.

Isolation, identification, and significance of salivary Veillonella spp., Prevotella spp., and Prevotella salivae in patients with inflammatory bowel disease

“…P. salivae , despite being an often overlooked pathogen, has demonstrated its involvement in various conditions, including periodontitis ( Sakamoto et al., 2004 ), infections within root canals, periapical abscesses ( Hsiao et al., 2012 ), and caries ( Jiang et al., 2016 ). Moreover, case reports have further linked P. salivae to peritonitis ( Domingues et al., 2023 ) and bacteremia ( Avanzato et al., 2023 ).…”