Iskustvo sa primenom kolistina u lečenju peritonitisa kod imunokompromitovanih bolesnika na peritoneumskoj dijalizi

  • Tatjana Djurdjević Mirković Clinic for Nephrology and Clinical Immunology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
  • Ljiljana Gvozdenović Clinic for Anesthesiology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
  • Gordana Majstorović-Stražmešter Clinic for Nephrology and Clinical Immunology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
  • Violeta Knežević Clinic for Nephrology and Clinical Immunology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
  • Dejan Ćelić Clinic for Nephrology and Clinical Immunology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
  • Siniša Mirković Clinic for dentistry of Vojvodina Medical faculty Novi Sad University of Novi Sad
  • Milica Popović Clinic for Nephrology and Clinical Immunology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
DOI: https://doi.org/10.2298/5254
Ključne reči: multiple myeloma||, ||multipli mijelom, peritoneal dialysis||, ||dijaliza, peritoneumska, peritonitis||, ||peritonitis, colistin||, ||kolistin,

Sažetak


Uvod. Imunokompromitovani bolesnici, kao što su bolesnici sa multiplim mijelomom na peritoneumskoj dijalizi, posebno su skoloni nastanku peritonitisa. Prikaz bolesnika. Prikazali smo bolesnicu, staru 56 godina, koja je bolovala od multiplog mijeloma 10 godina. Od 2010. god. lečila se metodom peritoneumske dijalize. Prvu epizodu peritonitisa koja je uspešno sanirana, imala je tokom 2012. U 2013. ponovo je došlo do razvoja peritonitisa. Analizom kulture dijalizata i brisom izlaznog mesta peritoneumskog katetera izolovan je multirezistentni Acinetrobacter spp, osetljiv samo na kolistin. Primenom kolistina u dozi od 100 000 jedinica/dan tokom šest dana došlo je do potpunog poboljšanja opšteg stanja bolesnice, kao i lokalnog nalaza na trbuhu. Gram-negativna bakterija (Acinetobacter spp) čest je uzročnik hospitalnih infekcija. Istraživanja potvrđuju osetljivost Acinetobacter spp. na kolistin, što je slučaj kod prikazane bolesnice. Intravenska primena kolistina rezultovala je potpunim oporavkom od teškog, po život opasnog, peritonitisa. Zaključak. Bolesnici sa multiplim mijelomom i bubrežnom insuficijencijom imaju povećanu sklonost ka nastanku teških, po život opasnih, infekcija.

Reference

Rabrenović V, Kovacević Z, Jovanović D, Rabrenović M, Milović N, Cerović S. Extramedular plasmacytoma in the urinary bladder-unusual localization. Vojnosanit Pregl 2006; 63(11): 975−8. (Serbian)

Korzets A, Tam F, Russell G, Feehally J, Walls J. The role of con-tinuous ambulatory peritoneal dialysis in end-stage renal failure due to multiple myeloma. Am J Kidney Dis 1990; 16(3): 216−23.

Shetty A, Oreopoulos DG. Continuous ambulatory peritoneal di-alysis in end-stage renal disease due to multiple myeloma. Perit Dial Int 1995; 15(6): 236−40.

Ha JF, Chandraratna H. Laparoscopic cholecystectomy in chronic ambulatory peritoneal dialysis. Ochsner J 2009; 9(1): 17−9.

Jain AK, Blake PG. Non-Pseudomonas Gram-negative perito-nitis. Kidney Int 2006; 69(7): 1107−9.

Szeto CC, Chow KM. Gram-negative peritonitis - The Achilles leel of peritoneal dialysis. Perit Dial Int 2007; 27(2): 267−71.

Borrego-Hinojosa J, Pérez-del Barrio MP, Biechy-Baldan Mdel M, Merino-García E, Sánchez-Perales MC, García-Cortés MJ, et al. Treatment by long haemodialysis sessions with high cut-off filters in myeloma cast nephropathy: our experience. Nefro-logía 2013; 33(4): 515−23. (English, Spanish)

França MS, Lima SS, Duclou CN, Goulart EM, de Romanelli RM. Antimicrobials and renal failure in neutropenic patients. Braz J Infect Dis 2013; 17(4): 487−90.

Pérez Fontan M, Rodríguez-Carmona A, García-Naveiro R, Rosales M, Villaverde P, Valdés F. Peritonitis-related mortality in patients undergoing chronic peritoneal dialysis. Perit Dial Int 2005; 25(3): 274−84.

Djurdjević-Mirković T. Peritoneal dialysis – Our experience. Med Pregl 2010; 63(11): 753−7. (Serbian)

Gvozdenović L, Knežević V, Knežević A, Gvozdenović N, Gojković Z. National estimates of severe sepsis (our experience in Novi Sad, Serbia). Braz J Infect Dis 2013; 17(3): 381−2.

Yang S, Yoon HJ, Ki MR. Risk factors for mortality in Acine-tobacter bacteremia. Braz J Infect Dis 2011; 15(5): 501−2.

Prata-Rocha ML, Gontijo-Filho PP, de Melo GB. Factors influen-cing survival in patients with multidrug-resistant Acinetobacter baumannii infection. Braz J Infect Dis 2012; 16(3): 237−41.

Chu H, Zhao L, Wang M, Liu Y, Gui T, Zhang J. Sulbactam-based therapy for Acinetobacter baumannii infection: a systematic review and meta-analysis. Braz J Infect Dis 2013; 17(4): 389−94.

Li PK, Szeto CC, Piraino B, Bernardini J, Figueiredo AE, Gupta A, et al. Peritoneal dialysis - related infections recommendations: 2010 update. Perit Dial Int 2010; 30(4): 393−423.

Netto B, Vieira BJ, Hermes DM, Ribeiro VB, Zavascki AP. In vitro activity of non-bactericidal concentrations of polymyxin B in combination with other antimicrobials against OXA-23-producing carbapenem-resistant Acinetobacter baumannii. Braz J Infect Dis 2013; 17(4): 502−4.

Medić D, Mihajlović-Ukropina M, Gusman V, Jelesić Z, Milosavljević B. Carbapenems resistance of Acinetobacter spp strains isolated from wound SWABS during 2009-2010. Med Pregl 2011; 64(11−12): 583−7.

Perez-Fonatan M, Rodriguez-Carmona A. Peritoneal catheter re-moval for sever peritonitis: landscape after a lost battle. Perit Dial Int 2007;27:155.

Álvarez-Lara M, Martín-Malo A, Aljama-García P. New alterna-tives in the treatment of myeloma kidney. Nefrología 2013; 33(4): 443−7.

Objavljeno
2015/07/08
Broj časopisa
Vol. 72 Br. 4 (2015)
Rubrika
Prikaz bolesnika