ESPN 51th Annual Meeting

ESPN 2018


 
The first case report of peritoneal dialysis-related peritonitis in a child due to Microbacterium arborescens
─░LKNUR GIRISGEN 1 SELCUK YUKSEL 1 ─░LKNUR KALELI 2

1- PAMUKKALE UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF PEDIATRIC NEPHROLOGY
2- PAMUKKALE UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF MICROBIOLOGY
 
Introduction:

 Peritonitis is a serious problem in children who receive peritoneal dialysis (PD).

Material and methods:

 A 16-year-old girl who had end-stage renal failure and who had been treated with continuous ambulatory PD was admitted to our hospital. She has suffered from three peritonitis attacks within 30 days.  Microbacterium arborescens was isolated from her PD fluid culture during the last two peritonitis attacks. After the patient received intraperitoneal cefepime treatment, the PD catheter was removed. 

Results:

 Human infection due to the Microbacterium genus is very rare. Interestingly, Microbacterium arborescens, a facultative alkaliphile isolated from coastal sand dunes, is able produce large amounts of exopolysaccharide that was able to aggregate sand. Bacterial exopolysaccharide synthesis is a prevalent and indispensible activity in many biological processes, including surface adhesion and biofilm formation. We suggest that, in this case, Microbacterium arborescens led to the formation of a biofilm layer via the formation of exopolysaccharides, thus causing the recurrent peritonitis attacks.

Conclusions:

 To our knowledge, Microbacterium arborescens-caused peritonitis has not previously been reported in a child undergoing PD. Management of peritoneal dialysis-related peritonitis due to microorganisms which have ability to produce exopolysaccharide seems to be difficult without catheter withdrawal.