Korean J Nephrol.  2010 Sep;29(5):675-678.

A Case of Peritoneal Dialysis Peritonitis Due to Methicillin-Resistant Staphylococcus auricularis

• Choi JW
• Kim BK
• Hwang KS
• Park JS
• Lee CH
• Kang CM
• Kim GH

Abstract

Although coagulase-negative staphyloccus is the most common organism causing peritonitis in peritoneal dialysis (PD) patients, only one case of PD peritonitis due to Staphylococcus auricularis, the normal flora of external auditory meatus, has been reported over the world. Here we add a case of PD peritonitis caused by methicillin-resistant Staphylococcus auricularis, which was successfully treated with vancomycin. A 79-year-old male PD patient was admitted because of abdominal pain and cloudy peritoneal fluid. At admission, the exit site was clear, and no rebound tenderness was noted although the abdominal wall was diffusely tender. Gram stain of the peritoneal fluid did not reveal any organism, but white blood cell count was 1,210/mm3, with 80% polymorphonuclear cells and 10% lymphocytes. Empirical antibiotic therapy was started with intraperitoneal cefazolin and ceftazidime. Over the next few days, however, the peritoneal fluid was still turbid and showed an elevated cell count. Then, the result of peritoneal fluid culture identified that the organism was oxacillin-resistant Staphylococcus auricularis. Thus the antibiotics were switched into vancomycin, and intraperitoneal vancomycin 1 gm was administered three times at 5 days' intervals to achieve completely clear peritoneal fluid. Staphylococcus auricularis should be considered as a new potential skin organism causing PD peritonitis.

Keyword

Staphylococcus; Peritoneal dialysis; Peritonitis

MeSH Terms

Abdominal Pain
Abdominal Wall
Aged
Anti-Bacterial Agents
Ascitic Fluid
Cefazolin
Ceftazidime
Cell Count
Humans
Leukocyte Count
Lymphocytes
Male
Methicillin Resistance
Peritoneal Dialysis
Peritonitis
Skin
Staphylococcus
Vancomycin
Anti-Bacterial Agents
Cefazolin
Ceftazidime
Vancomycin