Peritoneal dialysis-related peritonitis caused by Gordonia bronchialis: first pediatric report

Valentina Bruno*, James Tjon, Sandy Lin, Helen Groves, Kescha Kazmi, Michael Zappitelli, Elizabeth Harvey

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Introduction: Gordonia species, aerobic, weakly acid-fast, Gram-positive bacilli, are a rare cause of peritonitis in patients undergoing peritoneal dialysis (PD). We report the first pediatric case of PD-related peritonitis caused by Gordonia bronchialis.

Case presentation: A 13-year-old girl with chronic kidney disease (CKD) stage 5D, on continuous cycling PD (CCPD) for 8 years, presented with cloudy PD effluent, with no abdominal discomfort or fever. Intra-peritoneal (IP) loading doses of vancomycin and ceftazidime were started at home after obtaining a PD effluent sample, which showed WBC 2,340 × 106/L (59% neutrophils) and Gram-positive bacilli. On admission, she was clinically well and afebrile, with no history of methicillin-resistant Staphylococcus aureus (MRSA) infection, so vancomycin was discontinued, and IP ceftazidime and cefazolin were started, following a loading dose of intravenous cefazolin. Gordonia species grew after 5 days of incubation and later identified as Gordonia bronchialis. IP vancomycin was restarted as monotherapy, empirically for a total of 3 weeks therapy. A 2-week course of oral ciprofloxacin was added, based on susceptibility testing. PD catheter replacement was advised due to the risk of recurrence but was refused. A relapse occurred 16 days after discontinuing antibiotics, successfully treated with a 2-week course of IP ceftazidime and vancomycin. The PD catheter was removed and hemodialysis initiated. She received a further 2-week course of oral ciprofloxacin and amoxicillin-clavulanate post PD catheter removal.

Conclusions: Gordonia bronchialis is an emerging pathogen in PD peritonitis and appears to be associated with a high risk of relapse. PD catheter replacement is strongly suggested.
Original languageEnglish
Pages (from-to)217-220
Number of pages4
JournalPediatric Nephrology
Early online date11 Oct 2021
Publication statusPublished - Jan 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to International Pediatric Nephrology Association.


  • Child
  • Gordonia bronchialis
  • Peritoneal dialysis
  • Peritonitis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology


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