POS-071 TREATMENT AND OUTCOMES OF PERITONITIS DUE TO ROTHIA SPECIES IN PATIENTS ON PERITONEAL DIALYSIS: A SYSTEMATIC CASE SUMMARY AND MULTICENTRE REGISTRY ANALYSIS

Peritoneal dialysis (PD)-associated peritonitis remains a severe complication of PD. Although peritonitis due to Rothia spp. is rare, the treatment recommendations and outcomes are uncertain. Our study aims to review (1) literature on peritonitis caused by Rothia spp. and (2) cases of peritonitis due to Rothia spp. in patients on PD in Australia and New Zealand. A literature search of PubMed, Scopus, Embase and Google Scholar for articles published between 1948 and 2022 was conducted using the search terms “Rothia”, “Stomatococcus”, “peritonitis”, and “peritoneal dialysis”. To be eligible, case reports had to describe antibiotic therapy and treatment outcomes in all PD patients for peritonitis caused by Rothia/Stomatococcus spp. Articles describing Rothia spp. as a contaminant and antibiotic therapy not directed at Rothia spp. were excluded. Data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry of PD patients who developed peritonitis due to Rothia spp. between 2011 and 2020 were also reviewed. A total of 11 case reports and 28 episodes were identified from the literature search and ANZDATA registry, respectively. Over 60% of the peritonitis cases due to Rothia spp. were reported in the literature search and the ANZDATA Registry were due to Rothia mucilaginosa (7/11 and 17/28, respectively), while Rothia dentacariosa was the second most commonly identified in both the literature search and the ANZDATA Registry (4/11 and 5/28, respectively). A majority 6 (54.5%) of the case reports in the literature search employed a combination antibiotic regimen [amoxycillin/clavulanic acid/amikacin (16.7%), cefazolin/netilmicin (16.7%), amoxicillin/rifampicin (16.7%), vancomycin/meropenem/linezolid/voriconazole (16.7%), vancomycin/rifampicin (16.7%), cefazolin/ceftazidime (16.7%)], while the remaining 5 (45.5%) used single antibiotic regimen [vancomycin (80%), cefazolin (20%)]. In contrast, most of the episodes, 22 (78.6%) described in the ANZDATA Registry, employed a single antibiotic regimen [vancomycin (57.1%), cefazolin (14.3%), amoxicillin (3.6%) and amoxicillin/clavulanate acid (3.6%)], and only 6 (21.4%) episodes were treated with a combination antibiotic regimen [ceftazidime/vancomycin (10.7%), cefazolin/gentamicin (3.5%), flucloxacillin/ciprofloxacin (3.5%), and gentamicin/vancomycin (3.5%)]. The duration of antibiotic therapy in both the literature search and the ANZDATA Registry ranged between two-to-three weeks. While no deaths within 30-days of developing peritonitis were reported in both the literature search and the ANZDATA Registry, catheter removal was reported in 4 (36.4%) and 1(3.6%) instances, respectively. PD-associated peritonitis due to Rothia spp. is uncommon and associated with relatively good outcomes.