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Journal of Clinical Microbiology, June 1998, p. 1781-1783, Vol. 36, No. 6
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Peritonitis Associated with Vancomycin-Resistant Lactobacillus rhamnosus in a Continuous Ambulatory Peritoneal Dialysis Patient: Organism Identification, Antibiotic Therapy, and Case Report

Günter Klein,1,* Edith Zill,2 Ralf Schindler,3 and Jacobus Louwers1

Institute of Meat Hygiene and Technology, Veterinary Faculty, Free University of Berlin, 14195 Berlin,1 and Department of Microbiology,2 and Department of Nephrology and Intensive Care Medicine,3 Charité-Virchow-Clinic, Humboldt University of Berlin, 13353 Berlin, Germany

Received 20 January 1998/Returned for modification 20 February 1998/Accepted 24 March 1998

A case of Lactobacillus rhamnosus-associated peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis is reported. The patient was treated with vancomycin after isolation of glycopeptide-susceptible coagulase-negative staphylococci. After a skin rash developed, vancomycin was discontinued and replaced with teicoplanin. Seven weeks after the glycopeptide therapy was discontinued, a Lactobacillus strain was isolated in pure cultures. The isolate was identified first incorrectly as L. acidophilus but later correctly as L. rhamnosus. Antibiotic susceptibility testing showed that the isolate was resistant to glycopeptides but susceptible to several other antibiotics. The antibiotic treatment was then switched to imipenem and was successful.

* Corresponding author. Mailing address: Institute of Meat Hygiene and Technology, Veterinary Faculty, Free University of Berlin, Brümmerstr. 10, D-14195 Berlin (Dahlem), Germany. Phone: 49-30-838-2793. Fax: 49-30-838-2792. E-mail: gklein{at}zedat.fu-berlin.de.

Journal of Clinical Microbiology, June 1998, p. 1781-1783, Vol. 36, No. 6
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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