The first case of peritoneal dialysis-associated peritonitis caused by Gordonia otitidis

The first case of peritoneal dialysis-associated peritonitis caused by Gordonia otitidis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report The first case of peritoneal dialysis-associated peritonitis caused by Gordonia otitidis Tomoaki Miyazaki, Kei Matsumoto, Shugo Aoki, Akiko Takeshima This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5436641/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 04 Sep, 2025 Read the published version in Renal Replacement Therapy → Version 1 posted You are reading this latest preprint version Abstract Background Gordonia spp. is a rare infectious disease that has been reported in only 18 cases to date as a cause of peritoneal dialysis-related peritonitis. This is the first report of peritonitis associated with peritoneal dialysis caused by Gordonia otitidis and is a valuable case in which long-term intravenous vancomycin administration was successful. Case presentation A 48-year-old female. She started peritoneal dialysis at the age of 47 years due to end-stage renal failure caused by chronic glomerulonephritis. She was hospitalized for peritonitis three months after the start of dialysis. We administered cefazolin and ceftazidime intravenously and detected Gordonia otitidis in the drainage fluid after long-term culture for approximately 6 days. Therefore, we switched to vancomycin and treated the patient intravenously for a total of 6 weeks while checking blood levels and trough values in the drainage fluid. The patient had an increase in the number of draining cells for 3 weeks after the start of treatment, but the number of draining cells improved after that, and no relapse was observed 6 months after the end of treatment, suggesting that the treatment was successful. Conclusions When encountering peritoneal dialysis-associated peritonitis for the Gordonia genus, long-term intravenous administration of vancomycin should be considered as one of the treatments. Gordonia otitidis peritonitis peritoneal dialysis vancomycin Figures Figure 1 Background The Gordonia genus is a group of aerobic actinomycetes that are widely distributed in nature and have been classified into 53 species to date. It has been reported to be a causative agent of catheter infections and opportunistic infections[ 1 ]. To date, only 16 cases of peritoneal dialysis-associated peritonitis caused by the Gordonia genus have been reported. In 9 patients, the peritoneal dialysis catheter was removed due to recurrence, and the treatment method remains undetermined. Furthermore, there have been no reports of peritonitis caused by Gordonia otitidis to date. This is the first reported case of peritoneal dialysis-associated peritonitis caused by Gordonia otitidis , and we report this rare case in which long-term intravenous administration of vancomycin led to improvement without the need for removal of the peritoneal dialysis catheter. Case presentation The patient was a 48-year-old woman. At the age of 47, she was introduced to peritoneal dialysis at our hospital due to end-stage renal failure caused by chronic glomerulonephritis. Peritoneal dialysis was initiated via the Terumo ClickSafe® manual connection system. Three months after starting peritoneal dialysis, she had a fever of 38.6°C and abdominal pain and noticed that the peritoneal dialysis effluent was cloudy, so she visited our hospital. She was suspected of having peritoneal dialysis-associated peritonitis, and she was admitted on the same day. On admission, she had lower abdominal tenderness, rebound tenderness, and swelling in both lower legs. She had no redness around the exit site of the peritoneal dialysis catheter. The white blood cell counts and C-reactive protein level in the blood were 2480/μL and 4.91 mg/dL, respectively, and the white blood cell count in the peritoneal dialysis effluent was 650/μL. The laboratory data obtained at admission are summarized in Table 1. Two sets of blood cultures were negative, but Gordonia otitidis was cultured from the peritoneal dialysis effluent on the sixth day after the start of culture. Prior to the onset of symptoms, the patient dropped the ClickSafe® cap, which is used for manual replacement of TERUMO peritoneal dialysis equipment, on the floor several times and continued to use it, so it was thought that the peritonitis was due to contact contamination. Previous studies have reported that vancomycin can be used as a treatment for Gordonia spp., with treatment durations varying widely from 2-7 weeks. On the basis of case reports of no recurrence, a 6-week treatment period was selected, and vancomycin was administered intravenously. Blood trough levels and peritoneal dialysis effluent trough levels were measured periodically, and the administration interval was adjusted. The patient was discharged on the 22nd day after the onset of symptoms and continued to visit the hospital as an outpatient, receiving antibiotics for a total of 6 weeks (Figure). After that, there was no increase in the drainage cell count, so the treatment was completed. Discussion and Conclusions The genus Gordonia may have gone undetected previously because it requires a long incubation period, approximately 6 days, before it can be detected by culture[2]. Gordonia otitidis is a bacterium of the genus Gordonia that was newly classified in 2012, and genetic analysis or mass spectrometry is needed to identify this species. In this case, the species was identified via mass spectrometry. To date, 16 cases of peritoneal dialysis-associated peritonitis caused by the Gordonia genus have been reported[3-13], and 9 of these cases resulted in removal of the peritoneal dialysis catheter (Table 2). For treatment, even if the bacteria are susceptible, there is a high possibility of removal of the peritoneal dialysis catheter unless amikacin or vancomycin is used. In addition, although the Peritoneal Dialysis Guidelines recommend the intraperitoneal administration of antibiotics, Lam et al. reported that systemic intravenous administration of vancomycin or carbapenem was necessary for the treatment of Gordonia peritonitis, regardless of the removal of the peritoneal dialysis catheter [7]. In this case, the antibiotic sensitivity of the detected Gordonia otitidis was good, except for that of clindamycin and fosfomycin (Table 3). In addition to previous reports, we chose intravenous administration because it was easy to perform outpatient treatment since the blood and drainage concentrations were maintained every 5-6 days. The treatment was successful without the need to remove the peritoneal dialysis catheter, and there has been no evidence of recurrence in the more than six months since the end of treatment. This is the first case of peritoneal dialysis-associated peritonitis caused by Gordonia otitidis , and we believe it is an extremely valuable case in which treatment was possible without the need for removal of the peritoneal dialysis catheter through long-term intravenous administration of vancomycin. When encountering peritoneal dialysis-associated peritonitis, long-term culture should be performed with the Gordonia genus in mind, and if it is detected, long-term intravenous administration of vancomycin should be considered as one of the treatments. Declarations Ethics approval and consent to participate This patient consented to participate. Consent for publication This patient consented for publication. Availability of data and materials All data generated or analyzed during this study are included in this published article. Competing interests The authors declare that they have no competing interests. Funding No funding was obtained for this study. Authors' contributions TM was a major contributor in writing the manuscript. KM, SA, and AT conducted the literature search and contributed to the treatment. All authors read and approved the final manuscript. Acknowledgements Not applicable. References Pino-Rosa S, Medina-Pascual MJ, Carrasco G, Garrido N, Villalón P, Valiente M, Valdezate S. Focusing on Gordonia Infections: Distribution, Antimicrobial Susceptibilities and Phylogeny. Antibiotics (Basel). 2023;12:1568. Kobayashi T, Otake S, Mori T, Hasegawa D, Kosaka Y, Ohkusu K, Kasai M. A pediatric case of Gordonia otitidis bacteremia detected by long-term blood culture. J Infect Chemother. 2022;28:1427-9. Imran M, Livesley P, Bell G, Pai P, Neal T, Anijeet H. Gordona: a rare cause of peritoneal dialysis peritonitis. Perit Dial Int. 2012;32:344-6. Gardenier JC, Sawyer RG, Sifri CD, Brayman K, Wispelway B, Bonatti H. Peritonitis caused by Haemophilus parainfluenzae , Leifsonia aquatica, and Gordonia spp. in a patient undergoing continuous ambulatory peritoneal dialysis. Surg Infect (Larchmt). 2012;13:409-12. Ou SM, Lee SY, Chen JY, Cheng HW, Wei TH, Yu KW, Lin WM, King KL, Yang WC, Ng YY. First identification of Gordonia sputi in a continuous ambulatory peritoneal dialysis patient with Peritonitis. Perit Dial Int. 201333:107-8. Ma TK, Chow KM, Kwan BC, Lee KP, Leung CB, Li PK, Szeto CC. Peritoneal-dialysis related peritonitis caused by Gordonia species: report of four cases and literature review. Nephrology (Carlton). 2014;19:379-83. Lam JY, Wu AK, Leung WS, Cheung I, Tsang CC, Chen JH, Chan JF, Tse CW, Lee RA, Lau SK, Woo PC. Gordonia species as emerging causes of continuous-ambulatory-peritoneal-dialysis-related peritonitis identified by 16S rRNA and secA1 gene sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). J Clin Microbiol. 2015;53:671-6. Zhang Ting-ting, Xue Wen-cheng, Wang Hong. Dialysis-related peritonitis caused by Gordonia sputi in patient with chronic renal failure: case report and review of the literature. Reviews in Medical Microbiology. 2015;26:111-3. Tsang CC, Xiong L, Poon RWS, Chen JHK, Leung KW, Lam JYW, Wu AKL, Chan JFW, Lau SKP, Woo PCY. Gordonia hongkongensis sp. nov., isolated from blood culture and peritoneal dialysis effluent of patients in Hong Kong. Int J Syst Evol Microbiol. 2016;66:3942-50. Hou C, Yang Y, Li Z. A Chinese patient with peritoneal dialysis-related peritonitis caused by Gordonia terrae: a case report. BMC Infect Dis. 2017;17:179. Sukackiene D, Rimsevicius L, Kiveryte S, Marcinkeviciene K, Bratchikov M, Zokaityte D, Tyla R, Laucyte-Cibulskiene A, Miglinas M. A case of successfully treated relapsing peritoneal dialysis-associated peritonitis caused by Gordonia bronchialis in a farmer. Nephrol Ther. 2018;14:109-11. Bruno V, Tjon J, Lin S, Groves H, Kazmi K, Zappitelli M, Harvey E. Peritoneal dialysis-related peritonitis caused by Gordonia bronchialis: first pediatric report. Pediatr Nephrol. 2022;37:217-20. Wang B, Cui Z, Yu S, Sun D, Zhang W, Jin X, Cheng X, Chen Y. Rapid detection of Gordonia aichiensis by metagenomic next-generation sequencing in a patient with peritoneal dialysis-associated peritonitis. Perit Dial Int. 2022;42:542-5. Tables Tables 1 to 3 are available in the Supplementary Files section Additional Declarations No competing interests reported. Supplementary Files Table1.xlsx Table2.xlsx Table3.xlsx Cite Share Download PDF Status: Published Journal Publication published 04 Sep, 2025 Read the published version in Renal Replacement Therapy → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5436641","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":378431861,"identity":"76f002b3-2582-495d-9fb6-69c10569ddcc","order_by":0,"name":"Tomoaki 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actinomycetes that are widely distributed in nature and have been classified into 53 species to date. It has been reported to be a causative agent of catheter infections and opportunistic infections[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. To date, only 16 cases of peritoneal dialysis-associated peritonitis caused by the \u003cem\u003eGordonia\u003c/em\u003e genus have been reported. In 9 patients, the peritoneal dialysis catheter was removed due to recurrence, and the treatment method remains undetermined. Furthermore, there have been no reports of peritonitis caused by \u003cem\u003eGordonia otitidis\u003c/em\u003e to date. This is the first reported case of peritoneal dialysis-associated peritonitis caused by \u003cem\u003eGordonia otitidis\u003c/em\u003e, and we report this rare case in which long-term intravenous administration of vancomycin led to improvement without the need for removal of the peritoneal dialysis catheter.\u003c/p\u003e"},{"header":"Case presentation","content":"\u003cp\u003eThe patient was a 48-year-old woman. At the age of 47, she was introduced to peritoneal dialysis at our hospital due to end-stage renal failure caused by chronic glomerulonephritis. Peritoneal dialysis was initiated via the Terumo ClickSafe® manual connection system. Three months after starting peritoneal dialysis, she had a fever of 38.6°C and abdominal pain and noticed that the peritoneal dialysis effluent was cloudy, so she visited our hospital. She was suspected of having peritoneal dialysis-associated peritonitis, and she was admitted on the same day. On admission, she had lower abdominal tenderness, rebound tenderness, and swelling in both lower legs. She had no redness around the exit site of the peritoneal dialysis catheter. The white blood cell counts and C-reactive protein level in the blood were 2480/μL and 4.91 mg/dL, respectively, and the white blood cell count in the peritoneal dialysis effluent was 650/μL. The laboratory data obtained at admission are summarized in Table 1. Two sets of blood cultures were negative, but \u003cem\u003eGordonia otitidis\u003c/em\u003e was cultured from the peritoneal dialysis effluent on the sixth day after the start of culture. Prior to the onset of symptoms, the patient dropped the ClickSafe® cap, which is used for manual replacement of TERUMO peritoneal dialysis equipment, on the floor several times and continued to use it, so it was thought that the peritonitis was due to contact contamination. Previous studies have reported that vancomycin can be used as a treatment for \u003cem\u003eGordonia\u003c/em\u003e spp., with treatment durations varying widely from 2-7 weeks. On the basis of case reports of no recurrence, a 6-week treatment period was selected, and vancomycin was administered intravenously. Blood trough levels and peritoneal dialysis effluent trough levels were measured periodically, and the administration interval was adjusted. The patient was discharged on the 22nd day after the onset of symptoms and continued to visit the hospital as an outpatient, receiving antibiotics for a total of 6 weeks (Figure). After that, there was no increase in the drainage cell count, so the treatment was completed.\u003c/p\u003e"},{"header":"Discussion and Conclusions","content":"\u003cp\u003eThe genus \u003cem\u003eGordonia\u003c/em\u003e may have gone undetected previously because it requires a long incubation period, approximately 6 days, before it can be detected by culture[2]. \u003cem\u003eGordonia otitidis\u003c/em\u003e is a bacterium of the genus \u003cem\u003eGordonia\u003c/em\u003e that was newly classified in 2012, and genetic analysis or mass spectrometry is needed to identify this species. In this case, the species was identified via mass spectrometry.\u003c/p\u003e\n\u003cp\u003eTo date, 16 cases of peritoneal dialysis-associated peritonitis caused by the \u003cem\u003eGordonia\u003c/em\u003e genus have been reported[3-13], and 9 of these cases resulted in removal of the peritoneal dialysis catheter (Table 2). For treatment, even if the bacteria are susceptible, there is a high possibility of removal of the peritoneal dialysis catheter unless amikacin or vancomycin is used. In addition, although the Peritoneal Dialysis Guidelines recommend the intraperitoneal administration of antibiotics, Lam et al. reported that systemic intravenous administration of vancomycin or carbapenem was necessary for the treatment of \u003cem\u003eGordonia\u003c/em\u003e peritonitis, regardless of the removal of the peritoneal dialysis catheter [7]. In this case, the antibiotic sensitivity of the detected \u003cem\u003eGordonia otitidis\u003c/em\u003e was good, except for that of clindamycin and fosfomycin (Table 3). In addition to previous reports, we chose intravenous administration because it was easy to perform outpatient treatment since the blood and drainage concentrations were maintained every 5-6 days. The treatment was successful without the need to remove the peritoneal dialysis catheter, and there has been no evidence of recurrence in the more than six months since the end of treatment.\u003c/p\u003e\n\u003cp\u003eThis is the first case of peritoneal dialysis-associated peritonitis caused by \u003cem\u003eGordonia otitidis\u003c/em\u003e, and we believe it is an extremely valuable case in which treatment was possible without the need for removal of the peritoneal dialysis catheter through long-term intravenous administration of vancomycin. When encountering peritoneal dialysis-associated peritonitis, long-term culture should be performed with the \u003cem\u003eGordonia\u003c/em\u003e genus in mind, and if it is detected, long-term intravenous administration of vancomycin should be considered as one of the treatments.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis patient consented to participate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis patient consented for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was obtained for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTM was a major contributor in writing the manuscript. KM, SA, and AT conducted the literature search and contributed to the treatment. \u0026nbsp;All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003ePino-Rosa S, Medina-Pascual MJ, Carrasco G, Garrido N, Villal\u0026oacute;n P, Valiente M, Valdezate S. Focusing on \u003cem\u003eGordonia\u003c/em\u003e Infections: Distribution, Antimicrobial Susceptibilities and Phylogeny. Antibiotics (Basel). 2023;12:1568.\u003c/li\u003e\n \u003cli\u003eKobayashi T, Otake S, Mori T, Hasegawa D, Kosaka Y, Ohkusu K, Kasai M. A pediatric case of Gordonia otitidis bacteremia detected by long-term blood culture. J Infect Chemother. 2022;28:1427-9.\u003c/li\u003e\n \u003cli\u003eImran M, Livesley P, Bell G, Pai P, Neal T, Anijeet H. Gordona: a rare cause of peritoneal dialysis peritonitis. Perit Dial Int. 2012;32:344-6.\u003c/li\u003e\n \u003cli\u003eGardenier JC, Sawyer RG, Sifri CD, Brayman K, Wispelway B, Bonatti H. Peritonitis caused by \u003cem\u003eHaemophilus parainfluenzae\u003c/em\u003e, Leifsonia aquatica, and Gordonia spp. in a patient undergoing continuous ambulatory peritoneal dialysis. Surg Infect (Larchmt). 2012;13:409-12.\u003c/li\u003e\n \u003cli\u003eOu SM, Lee SY, Chen JY, Cheng HW, Wei TH, Yu KW, Lin WM, King KL, Yang WC, Ng YY. First identification of Gordonia sputi in a continuous ambulatory peritoneal dialysis patient with Peritonitis. Perit Dial Int. 201333:107-8.\u003c/li\u003e\n \u003cli\u003eMa TK, Chow KM, Kwan BC, Lee KP, Leung CB, Li PK, Szeto CC. Peritoneal-dialysis related peritonitis caused by Gordonia species: report of four cases and literature review. Nephrology (Carlton). 2014;19:379-83.\u003c/li\u003e\n \u003cli\u003eLam JY, Wu AK, Leung WS, Cheung I, Tsang CC, Chen JH, Chan JF, Tse CW, Lee RA, Lau SK, Woo PC. Gordonia species as emerging causes of continuous-ambulatory-peritoneal-dialysis-related peritonitis identified by 16S rRNA and secA1 gene sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). J Clin Microbiol. 2015;53:671-6.\u003c/li\u003e\n \u003cli\u003eZhang Ting-ting, Xue Wen-cheng, \u0026nbsp;Wang Hong. Dialysis-related peritonitis caused by Gordonia sputi in patient with chronic renal failure: case report and review of the literature. Reviews in Medical Microbiology. 2015;26:111-3.\u003c/li\u003e\n \u003cli\u003eTsang CC, Xiong L, Poon RWS, Chen JHK, Leung KW, Lam JYW, Wu AKL, Chan JFW, Lau SKP, Woo PCY. Gordonia hongkongensis sp. nov., isolated from blood culture and peritoneal dialysis effluent of patients in Hong Kong. Int J Syst Evol Microbiol. 2016;66:3942-50.\u003c/li\u003e\n \u003cli\u003eHou C, Yang Y, Li Z. A Chinese patient with peritoneal dialysis-related peritonitis caused by Gordonia terrae: a case report. BMC Infect Dis. 2017;17:179.\u003c/li\u003e\n \u003cli\u003eSukackiene D, Rimsevicius L, Kiveryte S, Marcinkeviciene K, Bratchikov M, Zokaityte D, Tyla R, Laucyte-Cibulskiene A, Miglinas M. A case of successfully treated relapsing peritoneal dialysis-associated peritonitis caused by Gordonia bronchialis in a farmer. Nephrol Ther. 2018;14:109-11.\u003c/li\u003e\n \u003cli\u003eBruno V, Tjon J, Lin S, Groves H, Kazmi K, Zappitelli M, Harvey E. Peritoneal dialysis-related peritonitis caused by Gordonia bronchialis: first pediatric report. Pediatr Nephrol. 2022;37:217-20.\u003c/li\u003e\n \u003cli\u003eWang B, Cui Z, Yu S, Sun D, Zhang W, Jin X, Cheng X, Chen Y. Rapid detection of \u003cem\u003eGordonia aichiensis\u003c/em\u003e by metagenomic next-generation sequencing in a patient with peritoneal dialysis-associated peritonitis. Perit Dial Int. 2022;42:542-5.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 3 are available in the Supplementary Files section\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Gordonia otitidis, peritonitis, peritoneal dialysis, vancomycin","lastPublishedDoi":"10.21203/rs.3.rs-5436641/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5436641/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eGordonia \u003c/em\u003espp. is a rare infectious disease that has been reported in only 18 cases to date as a cause of peritoneal dialysis-related peritonitis. This is the first report of peritonitis associated with peritoneal dialysis caused by \u003cem\u003eGordonia otitidis\u003c/em\u003eand is a valuable case in which long-term intravenous vancomycin administration was successful.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase presentation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA 48-year-old female. She started peritoneal dialysis at the age of 47 years due to end-stage renal failure caused by chronic glomerulonephritis. She was hospitalized for peritonitis three months after the start of dialysis. We administered cefazolin and ceftazidime intravenously and detected \u003cem\u003eGordonia otitidis\u003c/em\u003e in the drainage fluid after long-term culture for approximately 6 days. Therefore, we switched to vancomycin and treated the patient intravenously for a total of 6 weeks while checking blood levels and trough values in the drainage fluid. The patient had an increase in the number of draining cells for 3 weeks after the start of treatment, but the number of draining cells improved after that, and no relapse was observed 6 months after the end of treatment, suggesting that the treatment was successful.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhen encountering peritoneal dialysis-associated peritonitis for the \u003cem\u003eGordonia\u003c/em\u003e genus, long-term intravenous administration of vancomycin should be considered as one of the treatments.\u003c/p\u003e","manuscriptTitle":"The first case of peritoneal dialysis-associated peritonitis caused by Gordonia otitidis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-18 09:34:47","doi":"10.21203/rs.3.rs-5436641/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b4018346-2e09-42e7-b798-a00c72e37480","owner":[],"postedDate":"December 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-08T16:03:49+00:00","versionOfRecord":{"articleIdentity":"rs-5436641","link":"https://doi.org/10.1186/s41100-025-00661-4","journal":{"identity":"renal-replacement-therapy","isVorOnly":false,"title":"Renal Replacement Therapy"},"publishedOn":"2025-09-04 15:57:23","publishedOnDateReadable":"September 4th, 2025"},"versionCreatedAt":"2024-12-18 09:34:47","video":"","vorDoi":"10.1186/s41100-025-00661-4","vorDoiUrl":"https://doi.org/10.1186/s41100-025-00661-4","workflowStages":[]},"version":"v1","identity":"rs-5436641","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5436641","identity":"rs-5436641","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}