Campylobacter peritonitis in continuous ambulatory peritoneal dialysis: report of eight cases and a review of the literature

Abstract

Continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis remains the most common complication of this form of renal replacement therapy and the potential causative organisms are many and varied. Campylobacter bacteria are unusual causes of peritonitis in CAPD patients and we report our experience with eight cases and review those cases reported in the literature. In many episodes, there is a strong association with acute enterocolitis, which may precede the onset of cloudy dialysate by many days. The method of spread of these organisms from the gastrointestinal tract to the peritoneal cavity remains speculative. Bacteremic transfer would appear the most likely route, although it is probable that no single mode of spread explains all episodes. The treatment of choice of Campylobacter peritonitis is with intraperitoneal aminoglycoside in combination with oral erythromycin. An awareness of the potential for Campylobacter to cause CAPD-associated peritonitis, particularly when diarrhea is a prominent feature, has resulted in this organism becoming increasingly isolated in our unit.