title: An experience with colistin applied in treatment of imunocompromised patients with peritonitis on peritoneal dialysis.
abstract: BACKGROUND
  Immunocompromised patients, such as those with multiple myeloma on peritoneal dialysis, are particularly susceptible to the occurrence of peritonitis.
  
  
  METHODS
  We presented a 56-year-old female patient with a 10-year history of multiple myeloma. The patient was on peritoneal dialysis since 2010. During 2012 the patient had the first episode of peritonitis that was successfully managed, but in 2013 the second episode of peritonitis occured. Analysis of dialysate culture and exit site swab revealed the presence of multiresistant Acinetobacter spp., which was susceptible only to colistin. Prompt colistin therapy was administered at the doses of 100,000 units/day during six days, which resulted in complete recovery of the patient, as well as improvement of local abdominal findings. Gram-negative bacteria (genus Acinetobacter) are common causative agents in hospital-acquired infections. Studies confirmed susceptibility of Acinetobacter to colistin, which was also the case with the presented patient. Intravenous administration of colistin resulted in a complete remission of this severe, life-threatening peritonitis.
  
  
  CONCLUSIONS
  Patients with multiple myeloma and renal failure are highly prone to severe life-threatening infections.
authors.forename: Tatjana Djurdjević
authors.initials: TD
authors.lastname: Djurdjević
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Gvozdenović
authors.forename: Gordana
authors.initials: G
authors.lastname: Majstorović-Strazmester
authors.forename: Violeta
authors.initials: V
authors.lastname: Knezević
authors.forename: Dejan
authors.initials: D
authors.lastname: Celić
authors.forename: Sinisa
authors.initials: S
authors.lastname: Mirković
authors.forename: Milica
authors.initials: M
authors.lastname: Popović
mesh_terms: D000150:Acinetobacter / Q000187:drug effects / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003091:Colistin / Q000008:administration & dosage*; D003428:Cross Infection; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000276:immunology; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin