I have a patietn that had relapsing enterococcal peritonitis treated with vancomycin initiatlly then had his catheter removed after the second episode. After 3 months of HD – a catheter was placed last month and within a month he now has VRE peritonitis. There is no obvious intraabdminal pathology on CT.

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Adam S, Doctor/MD from USA asked
I have a patietn that had relapsing enterococcal peritonitis treated with vancomycin initiatlly then had his catheter removed after the second episode. After 3 months of HD – a catheter was placed last month and within a month he now has VRE peritonitis. There is no obvious intraabdminal pathology on CT.

1 answer

The information provided is quite limited to specifically answer the question. It appears that some part of the body is colonized with enterococcus and use of vancomycin selected the VRE strain. Optimal but prolonged treatment of VRE could potentially salvage the PD catheter but the threshold for removal of PD catheter should be low in such a setting.

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