Severe Clostridioides difficile infection associated with intraperitoneal antibiotics

José Martín Alanís Naranjo; Edwin Ariel Morales Miranda

2022, Number 3

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Enf Infec Microbiol 2022; 42 (3)

**Severe Clostridioides difficile infection associated with intraperitoneal antibiotics**

Alanís NJM, Morales MEA

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Language: Spanish
References: 17
Page: 138-141
PDF size: 132.96 Kb.

ABSTRACT

Exposure to antibiotics is considered the most important risk factor for the development of Clostridioides difficile (CD) infection. There is limited information in the literature on the risk of CD infection with intraperitoneal antibiotic use.
We present the case of a 38-year-old patient, with a history of end-stage renal disease treated with continuous cyclic peritoneal dialysis (PD) with an episode of peritonitis associated with PD one month prior to admission; treated as outpatient with intraperitoneal antibiotics for 21 days (vancomycin plus ceftazidime). Peritoneal dialysis fluid without criteria for peritonitis (leukocytes 20/mm³, 30% polymorphonuclear). Cultures did not report isolation of pathogens. There was positive CD toxin a-b determination in feces. Vancomycin 125 mg orally every six hours was indicated. He was discharged due to clinical improvement after completing 10 days of antibiotic management.

REFERENCES

Kachrimanidou, M. y Malisiovas, N., “Clostridium difficileinfection: a comprehensive review”, Crit Rev Microbiol, 2011, 37: 178-187.
Sartelli, M., Di Bella, S., McFarland, L.V., Khanna, S.,Furuya-Kanamori, L., Abuzeid, N. et al., “Update of thewses guidelines for management of Clostridiodes (Clostridium)difficile infection in surgical patients”, World JEmerg Surg, 2019, 28 (14):8.
Wolfgram, D.F., Foster, D., Astor, B.C. y Chan, M.R.,“Development of Clostridium difficile colitis in peritonealdialysis patients treated for peritonitis” Perit DialInt, 2012, 32 (6): 666-668.4. Gupta, A. y Khanna, S.,
“Community-acquired Clostridium difficile infection:an increasing public health threat”, Infect Drug Resist,2014, 7: 63-72.
Guh, A.Y., Adkins, S.H., Li, Q., Bulens, S.N., Farley, M.M.,Smith, Z. et al., “Risk factors for community-associatedClostridium difficile infection in adults: a case-controlstudy”, Open Forum Infect Dis, 2017, 4 (4): ofx171.
Hensgens, M.P., Goorhuis, A., Dekker, O.M. y Kuijper,E.J., “Time interval of increased risk for Clostridium difficileinfection after exposure to antibiotics”, J AntimicrobChemother, 2012, 67: 742-748.
Johnson, S., Lavergne, V., Skinner, A.M., Gonzales-Luna,A.J., Garey, K.W., Kelly, C.P. et al., “Clinical PracticeGuideline by the Infectious Diseases Society of America(idsa) and Society for Healthcare Epidemiology of America(shea): 2021 Focused Update Guidelines on Managementof Clostridioides difficile Infection in Adults”, ClinInfect Dis, 2021, 73 (5): e1029-e1044.
O’Brien, M.A. y Mason, N.A., “Systemic absorption ofintraperitoneal antimicrobials in continuous ambulatoryperitoneal dialysis”, Clin Pharm, 192, 11: 246-254.
Montañés Pauls, B., Almiñana, M.A. y Casabó Alós, V.G.,“Vancomycin pharmacokinetics during continuous ambulatoryperitoneal dialysis in patients with peritonitis”,Eur J Pharm Sci, 2011, 43 (4): 212-216.
Johnson, C.A., Zimmerman, S.W. y Rogge, M., “Thepharmacokinetics of antibiotics used to treat peritonealdialysis-associated peritonitis”, Am J Kidney Dis, 1984,4 (1): 3-17.
Montañés Pauls, B., Almiñana, M.A. y Casabó Alós, V.G.,“Vancomycin pharmacokinetics during continuous ambulatoryperitoneal dialysis in patients with peritonitis”,Eur J Pharm Sci, 2011, 43 (4): 212-216.
Lam, E., Lien, Y.T.K., Kraft, W.K., Piraino, B., Vozmediano,V., Schmidt, S. et al., “Vancomycin in peritoneal dialysis:clinical pharmacology considerations in therapy”, PeritDial Int, 2020, 40 (4): 384-393.
Falbo Dos Reis, P., Barretti, P., Marinho, L., Balbi, A.L.,Awdishu, L. y Ponce, D., “Pharmacokinetics of intraperitonealvancomycin and amikacin in automated peritonealdialysis patients with peritonitis”, Front Pharmacol,2021, 12: 658014.
Tourkantonis, A. y Nicolaidis, P., “Pharmacokinetics ofceftazidime in patients undergoing peritoneal dialysis”,J Antimicrob Chemother, 1983, 12 Suppl A: 263-267.
Demotes-Mainard, F., Vinçon, G., Ragnaud, J.M., Morlat,P., Bannwarth, B. y Dangoumau, J., “Pharmacokineticsof intravenous and intraperitoneal ceftazidime in chronicambulatory peritoneal dialysis”, J Clin Pharmacol,1993, 33 (5): 475-479.
Stea, S., Bachelor, T., Cooper, M., De Souza, P., Koenig,K. y Bolton, W.K., “Disposition and bioavailability of ceftazidimeafter intraperitoneal administration in patientsreceiving continuous ambulatory peritoneal dialysis”, JAm Soc Nephrol, 1996, 7 (11): 2399-2402.
Grabe, D.W., Bailie, G.R., Eisele, G. y Frye, R.F., “Pharmacokineticsof intermittent intraperitoneal ceftazidime”,Am J Kidney Dis, 1999, 33 (1): 111-1117.