title: Peritoneal-dialysis related peritonitis caused by Gordonia species: report of four cases and literature review.
abstract: OBJECTIVE
  To investigate the clinical course and outcome of peritoneal dialysis-associated peritonitis secondary to Gordonia species.
  
  
  METHODS
  We reviewed all Gordonia peritonitis episodes occurring in a single dialysis unit from 1994 to 2013.
  
  
  RESULTS
  During the study period, four episodes of Gordonia peritonitis were recorded. All were male patients. One patient responded to vancomycin therapy. One patient had refractory peritonitis despite vancomycin, but responded to imipenem and amikacin combination therapy. One patient had relapsing peritonitis and required catheter removal. The fourth patient had an elective Tenckhoff catheter exchange. No patient died of peritonitis. Causative organism was not fully identified until 7 to 18 days of peritonitis.
  
  
  CONCLUSIONS
  Gordonia species is increasingly recognized to cause serious infections. In patients undergoing peritoneal dialysis, Gordonia peritonitis should be considered in case of refractory Gram-positive bacilli peritonitis, especially when the exact organism could not be identified one week after the onset of peritonitis. A close liaison with a microbiologist is needed for a timely diagnosis.
authors.affiliation: Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Terry King-Wing
authors.initials: TK
authors.lastname: Ma
authors.forename: Kai-Ming
authors.initials: KM
authors.lastname: Chow
authors.forename: Bonnie Ching-Ha
authors.initials: BC
authors.lastname: Kwan
authors.forename: Kin-Ping
authors.initials: KP
authors.lastname: Lee
authors.forename: Chi-Bon
authors.initials: CB
authors.lastname: Leung
authors.forename: Philip Kam-Tao
authors.initials: PK
authors.lastname: Li
authors.forename: Cheuk-Chun
authors.initials: CC
authors.lastname: Szeto
mesh_terms: D000193:Actinomycetales Infections / Q000209:etiology / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D020878:Device Removal / Q000379:methods; D019468:Disease Management; D033601:Gordonia Bacterium / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D007263:Infusions, Parenteral / Q000379:methods; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy*; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000379:methods; D010538:Peritonitis / Q000209:etiology / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D012008:Recurrence; D013845:Thienamycins / Q000008:administration & dosage*; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D014640:Vancomycin; D000077731:Meropenem
keywords: Gordonia; infection; peritonitis; renal failure; survival