Peritonitis with multiple rare environmental bacteria in a patient receiving long-term peritoneal dialysis

We describe a patient receiving long-term peritoneal dialysis who experienced 2 episodes of peritonitis in successive months caused by unusual bacteria of environmental origin: Agrobacterium radiobacter, Pseudomonas oryzihabitans, and Corynebacterium aquaticum. A radiobacter and P oryzihabitans occurred simultaneously in the first episode of peritonitis, and C aquaticum, in the second episode. The patient's vocation necessitated exposure to moist soiled conditions. Both episodes responded promptly to antibiotics commonly used to treat peritonitis. Although these organisms rarely lead to loss of life and commonly are considered to be contaminants, they can cause symptomatic peritonitis and peritoneal dialysis catheter loss. A review of previous case reports is included.