Nontuberculous Mycobacterium Peritonitis in Patients on Peritoneal Dialysis: A Scoping Review
Abstract
Early and accurate identification of causative microorganisms is essential for improving outcomes in peritoneal dialysis (PD)-associated peritonitis. However, nontuberculous mycobacterial (NTM) peritonitis remains difficult to diagnose and manage, often resulting in delayed treatment and unfavorable clinical outcomes. We conducted a scoping review to summarize the clinical features, microbiological profiles, treatment strategies, and outcomes of PD-associated NTM peritonitis. A total of 107 patients from 81 published reports were identified, including one patient treated at our institution. The mean age was 50.1 years, with a slight male predominance. Diabetes mellitus was the most common underlying cause of end-stage renal disease. Abdominal pain, fever, and cloudy dialysate were the most frequently reported symptoms, and exit-site infection was present in 55% of cases. Rapid-growing NTM species predominated, with Mycobacterium fortuitum being the most frequently identified organism. A substantial delay was observed between symptom onset and initiation of appropriate therapy. The mean duration of antimicrobial treatment was six months. PD catheters were removed in 90% of patients, and 69% were permanently transitioned to hemodialysis. The overall mortality rate during treatment was 18%. These findings suggest that NTM infection should be considered in cases of culture-negative peritonitis unresponsive to standard antibiotics. Early catheter removal combined with prolonged…
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