Peritoneal-dialysis related peritonitis caused by Gordonia species: report of four cases and literature review.

Aim: To investigate the clinical course and outcome of peritoneal dialysis-associated peritonitis secondary to Gordonia species.

Method: 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.

Conclusion: 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.