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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Peritonitis is the leading complication of peritoneal dialysis &#40;PD&#41;&#44; contributing to technique failure and hospitalisation&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleItalic">Pseudomonas mendocina</span> is a gram-negative non-fermentative rod that was first isolated by Palleroni and others in 1970 from soil and water samples&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> It is a low-virulence organism and is rarely encountered in clinical specimens or reported as a human pathogen&#46; Aragone <span class="elsevierStyleItalic">et al&#46;</span><a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> reported the first case of <span class="elsevierStyleItalic">P&#46; mendocina</span>&#44; as a human pathogen&#44; in a 63-year-old man with endocarditis&#46; Since this report&#44; four cases of infection have been reported<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#8211;7</span></a>&#58; three of endocarditis&#44;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4&#44;6</span></a> one of spondylodiscitis<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> and one of bacteremia<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">We describe the first case of <span class="elsevierStyleItalic">P&#46; mendocina</span> peritonitis in a young adult on PD and discuss its prognostic implications&#46; A 22-year-old male&#44; with chronic kidney disease stage 5d&#44; on automated PD &#40;APD&#41; for 15 months&#44; with no past infectious complications reported&#44; came to our country for a 6 month period&#46; On the 43rd day&#44; he was admitted with peritonitis&#46; Empiric antibiotherapy was initiated&#44; with intraperitoneal cefazolin and ceftazidime in a continuous inpatient PD regimen during 2 days&#44; as the patient was not familiar with intraperitoneal antibiotherapy&#46; His handling regarding PD was evaluated and no mistakes were found&#46; Oral ciprofloxacin &#40;250<span class="elsevierStyleHsp" style=""></span>mg 12&#47;12<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; was initiated empirically before discharge and the patient reinitiated his habitual APD regimen&#44; maintaining intraperitoneal ceftazidime and cefazolin&#46; The peritoneal fluid &#40;PF&#41; culture revealed <span class="elsevierStyleItalic">Pseudomonas mendocina</span>&#46; Cefazolin was interrupted and treatment was maintained for 21 days&#44; due to the good clinical evolution in the presence of two anti-pseudomonal antibiotics&#46; The domestic water &#40;in a rented flat with piped water and basic sanitation&#41; was analysed&#44; but contamination was not found&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Six days after the treatment the patient returned to the hospital with relapsing peritonitis&#46; Empirical intraperitoneal cefazolin and ceftazidime was reinitiated&#44; plus ciprofloxacin 500<span class="elsevierStyleHsp" style=""></span>mg 12&#47;12h and fluconazole 50<span class="elsevierStyleHsp" style=""></span>mg 24&#47;24h PO&#46; The Tenckhoff catheter was filled with alteplase&#46; As for the source of infection&#44; we reanalysed the domestic water and contamination with <span class="elsevierStyleItalic">P&#46; mendocina</span> was not found&#46; The bathroom was shared with other colleagues&#44; so suspicion of contamination of a wet shared towel remains the most likely source&#46; Housing conditions were evaluated and sharing of the bathroom and towels with his roommates was discouraged&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">PF culture came negative and leucocyte count &#60;10<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">3</span> was observed at 9th day&#46; Empirical therapy was prolonged for 21 days&#46; The patient had a recurrence 46 days after &#40;on his 137th day abroad&#41;&#46; Previous therapeutic scheme was initiated&#44; with exception for fluconazole which was increased to 200<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#46; Microbiological&#44; mycobacterium and fungal analysis came negative&#46; He returned to his country one week after and maintained the treatment for 28 days&#46; After 6 months&#44; this patient had no further recurrences or relapses&#46; He was asymptomatic and performing PD&#46; The PF cell count remains routinely negative&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">This case entails many self-limited factors that could be perpetuating the source of contamination &#40;staying in a foreign country and different daily routines or constraints to usual aseptic technique&#41;&#44; so it was decided not to remove the catheter as he returned home and presented asymptomatic&#44; with clear PF&#44; negative cell count and microorganism growth&#46; He evolved free of infectious complications and the evolution after these 6 months proved that <span class="elsevierStyleItalic">P&#46; mendocina</span> can be treated without removal of the catheter&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Some questions arose&#44; nevertheless&#46; Which was the source of infection for this rare microorganism&#63; Was there a perpetuating focus or inoculum while abroad&#44; as this infection resolved with a passive strategy of maintaining therapy&#63; Could these relapses be due to the antibiotic and dialytic regimens chosen or to the nature of this microorganism&#44; known to produce a bio-film&#63;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Was the longer course of antibiotics the key to resolution of this relapsing&#47;recurrent cycle&#63; Could the transference to continuous ambulatory PD &#40;CAPD&#41; and a longer course of therapy have been enough to cure the first episode&#63; The availability to form biofilm has addressed by transiently filling the Tenckhoff catheter with alteplase&#44; as it may be a role to prevent relapsing peritonitis&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Although its benefit has not been definitively established&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> no harm has been held up against&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Transference to CAPD&#44; despite being our normal procedure&#44; was not a choice due to logistic issues concerning supplies of allocation and the fact that this patient was not trained in CAPD technique&#46; Little is known about intermittent dosing requirement in patients treated with APD<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> and the treatment regimen was not of easy choice in this particular case&#46; Another remark concerning ceftazidime must be made&#44; as there are no data for this antibiotic for intermittent dosing in APD&#44; and its usage was based on equivalent dosing in CAPD for cefazolin&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Nevertheless&#44; we could concluded that it was not imperative to remove the catheter in this case of low-virulence bacteria belonging to <span class="elsevierStyleItalic">Pseudomonas spp</span>&#46; Further research is needed about <span class="elsevierStyleItalic">P&#46; mendocina</span>&#44; namely its antibiotic sensitivity and therapeutic duration for successful treatment&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Declarations</span><p id="par0045" class="elsevierStylePara elsevierViewall">Informed consent to publish individual data was obtained from the patient&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>1992&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prosthetic aortic valve&#44; Diabetes mellitus&#44; Poliomyelitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Fever&#44; chills&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Blood&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infective endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ceftriaxone<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>gentamicine &#40;6 weeks&#41; followed by ciprofloxacin &#40;2 weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>2001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Tetralogia de Fallot and previous cardiovascular surgeries&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Abdominal pain&#44; dyspnoea&#44; flu-like syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Blood&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infective endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ampicillin<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>gentamicin followed by ciprofloxacin &#40;7 weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>2005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Renal disease&#44; alcoholism&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Lower back pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Deep tissue pus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Spondylodiscitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cefepime followed by ciprofloxacin &#40;7 weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mentally retarded&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Fever&#44; weight loss&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Blood&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infective endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ceftazidime<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>amikacin &#40;6 weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a>2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Fever chills&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Blood&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bacteremia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Gentamicin<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ofloxacin &#40;2 weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">This case&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Chronic kidney disease&#44; peritoneal dialysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Abdominal pain&#44; cloudy effluent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peritoneal fluid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peritonitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ceftazidime<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ciprofloxacin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical manifestations and outcomes of reported cases of <span class="elsevierStyleItalic">P&#46; mendocina</span> infection&#46;</p>"
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Letter to the Editor
Pseudomonas mendocina: the first case of peritonitis on peritoneal dialysis
Pseudomonas mendocina: el primer caso de peritonitis en diálisis peritoneal
Teresa M. Jerónimoa,
Corresponding author
teresa_jeronimo@hotmail.com

Corresponding author.
, Anabela M. Guedesa,b, Sandra Stieglmairc, Raquel Guerreirod, Ceú Laranjoa, Idalécio Bernardoa, Pedro L. Nevesa,b
a Centro Hospitalar do Algarve, Nephrology Department, Rua Leão Penedo, 8000 Faro, Algarve, Portugal
b Universidade do Algarve, Campus da Penha, 8005-139 Faro, Algarve, Portugal
c Krankenhaus der Elisabethinen Linz, Fadingerstraße 1, 4020 Linz, Austria
d Centro Hospitalar do Algarve, Clinical Pathology Department, Rua Leão Penedo, 8000 Faro, Algarve, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Peritonitis is the leading complication of peritoneal dialysis &#40;PD&#41;&#44; contributing to technique failure and hospitalisation&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleItalic">Pseudomonas mendocina</span> is a gram-negative non-fermentative rod that was first isolated by Palleroni and others in 1970 from soil and water samples&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> It is a low-virulence organism and is rarely encountered in clinical specimens or reported as a human pathogen&#46; Aragone <span class="elsevierStyleItalic">et al&#46;</span><a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> reported the first case of <span class="elsevierStyleItalic">P&#46; mendocina</span>&#44; as a human pathogen&#44; in a 63-year-old man with endocarditis&#46; Since this report&#44; four cases of infection have been reported<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#8211;7</span></a>&#58; three of endocarditis&#44;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4&#44;6</span></a> one of spondylodiscitis<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> and one of bacteremia<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">We describe the first case of <span class="elsevierStyleItalic">P&#46; mendocina</span> peritonitis in a young adult on PD and discuss its prognostic implications&#46; A 22-year-old male&#44; with chronic kidney disease stage 5d&#44; on automated PD &#40;APD&#41; for 15 months&#44; with no past infectious complications reported&#44; came to our country for a 6 month period&#46; On the 43rd day&#44; he was admitted with peritonitis&#46; Empiric antibiotherapy was initiated&#44; with intraperitoneal cefazolin and ceftazidime in a continuous inpatient PD regimen during 2 days&#44; as the patient was not familiar with intraperitoneal antibiotherapy&#46; His handling regarding PD was evaluated and no mistakes were found&#46; Oral ciprofloxacin &#40;250<span class="elsevierStyleHsp" style=""></span>mg 12&#47;12<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; was initiated empirically before discharge and the patient reinitiated his habitual APD regimen&#44; maintaining intraperitoneal ceftazidime and cefazolin&#46; The peritoneal fluid &#40;PF&#41; culture revealed <span class="elsevierStyleItalic">Pseudomonas mendocina</span>&#46; Cefazolin was interrupted and treatment was maintained for 21 days&#44; due to the good clinical evolution in the presence of two anti-pseudomonal antibiotics&#46; The domestic water &#40;in a rented flat with piped water and basic sanitation&#41; was analysed&#44; but contamination was not found&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Six days after the treatment the patient returned to the hospital with relapsing peritonitis&#46; Empirical intraperitoneal cefazolin and ceftazidime was reinitiated&#44; plus ciprofloxacin 500<span class="elsevierStyleHsp" style=""></span>mg 12&#47;12h and fluconazole 50<span class="elsevierStyleHsp" style=""></span>mg 24&#47;24h PO&#46; The Tenckhoff catheter was filled with alteplase&#46; As for the source of infection&#44; we reanalysed the domestic water and contamination with <span class="elsevierStyleItalic">P&#46; mendocina</span> was not found&#46; The bathroom was shared with other colleagues&#44; so suspicion of contamination of a wet shared towel remains the most likely source&#46; Housing conditions were evaluated and sharing of the bathroom and towels with his roommates was discouraged&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">PF culture came negative and leucocyte count &#60;10<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">3</span> was observed at 9th day&#46; Empirical therapy was prolonged for 21 days&#46; The patient had a recurrence 46 days after &#40;on his 137th day abroad&#41;&#46; Previous therapeutic scheme was initiated&#44; with exception for fluconazole which was increased to 200<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#46; Microbiological&#44; mycobacterium and fungal analysis came negative&#46; He returned to his country one week after and maintained the treatment for 28 days&#46; After 6 months&#44; this patient had no further recurrences or relapses&#46; He was asymptomatic and performing PD&#46; The PF cell count remains routinely negative&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">This case entails many self-limited factors that could be perpetuating the source of contamination &#40;staying in a foreign country and different daily routines or constraints to usual aseptic technique&#41;&#44; so it was decided not to remove the catheter as he returned home and presented asymptomatic&#44; with clear PF&#44; negative cell count and microorganism growth&#46; He evolved free of infectious complications and the evolution after these 6 months proved that <span class="elsevierStyleItalic">P&#46; mendocina</span> can be treated without removal of the catheter&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Some questions arose&#44; nevertheless&#46; Which was the source of infection for this rare microorganism&#63; Was there a perpetuating focus or inoculum while abroad&#44; as this infection resolved with a passive strategy of maintaining therapy&#63; Could these relapses be due to the antibiotic and dialytic regimens chosen or to the nature of this microorganism&#44; known to produce a bio-film&#63;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Was the longer course of antibiotics the key to resolution of this relapsing&#47;recurrent cycle&#63; Could the transference to continuous ambulatory PD &#40;CAPD&#41; and a longer course of therapy have been enough to cure the first episode&#63; The availability to form biofilm has addressed by transiently filling the Tenckhoff catheter with alteplase&#44; as it may be a role to prevent relapsing peritonitis&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Although its benefit has not been definitively established&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> no harm has been held up against&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Transference to CAPD&#44; despite being our normal procedure&#44; was not a choice due to logistic issues concerning supplies of allocation and the fact that this patient was not trained in CAPD technique&#46; Little is known about intermittent dosing requirement in patients treated with APD<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> and the treatment regimen was not of easy choice in this particular case&#46; Another remark concerning ceftazidime must be made&#44; as there are no data for this antibiotic for intermittent dosing in APD&#44; and its usage was based on equivalent dosing in CAPD for cefazolin&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Nevertheless&#44; we could concluded that it was not imperative to remove the catheter in this case of low-virulence bacteria belonging to <span class="elsevierStyleItalic">Pseudomonas spp</span>&#46; Further research is needed about <span class="elsevierStyleItalic">P&#46; mendocina</span>&#44; namely its antibiotic sensitivity and therapeutic duration for successful treatment&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Declarations</span><p id="par0045" class="elsevierStylePara elsevierViewall">Informed consent to publish individual data was obtained from the patient&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Reference &#40;year&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Antibiotics &#40;duration&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Prognosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>1992&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prosthetic aortic valve&#44; Diabetes mellitus&#44; Poliomyelitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Fever&#44; chills&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Blood&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infective endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ceftriaxone<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>gentamicine &#40;6 weeks&#41; followed by ciprofloxacin &#40;2 weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>2001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Tetralogia de Fallot and previous cardiovascular surgeries&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Abdominal pain&#44; dyspnoea&#44; flu-like syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Blood&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infective endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ampicillin<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>gentamicin followed by ciprofloxacin &#40;7 weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>2005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Renal disease&#44; alcoholism&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Lower back pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Deep tissue pus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Spondylodiscitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cefepime followed by ciprofloxacin &#40;7 weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mentally retarded&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Fever&#44; weight loss&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Blood&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infective endocarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ceftazidime<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>amikacin &#40;6 weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a>2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Fever chills&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Blood&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bacteremia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Gentamicin<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ofloxacin &#40;2 weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">This case&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Chronic kidney disease&#44; peritoneal dialysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Abdominal pain&#44; cloudy effluent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peritoneal fluid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peritonitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ceftazidime<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ciprofloxacin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical manifestations and outcomes of reported cases of <span class="elsevierStyleItalic">P&#46; mendocina</span> infection&#46;</p>"
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Article information
ISSN: 20132514
Original language: English
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Idiomas
Nefrología (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

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