Peritonitis caused by Ewingella americana in a patient with peritoneal dialysis: a case report

Area of Science:

• Nephrology
• Infectious Diseases
• Microbiology

Background:

• Peritonitis is a common complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
• Staphylococcus aureus is the typical causative agent, guiding empiric antibiotic selection.
• This case highlights a less common etiology, Ewingella americana, necessitating alternative treatment strategies.

Purpose of the Study:

• To report a case of CAPD-associated peritonitis caused by Ewingella americana.
• To emphasize the distinct antibiotic susceptibility profile of E. americana compared to common pathogens.
• To inform treatment considerations for CAPD peritonitis when unusual bacteria are involved.

Main Methods:

• A case presentation of a 76-year-old female patient with chronic renal failure on CAPD.
• Microbiological examination to identify the causative pathogen.
• Analysis of the identified pathogen's antibiotic susceptibility.
• Clinical observation of treatment response to antibiotic modification.

Main Results:

• The patient presented with generalized abdominal pain, indicative of peritonitis.
• Ewingella americana was identified as the causative pathogen.
• The pathogen exhibited a different antibiotic susceptibility pattern compared to typical CAPD peritonitis organisms.
• Switching antibiotic therapy from vancomycin to amikacin led to accelerated recovery.

Conclusions:

• Ewingella americana can cause peritonitis in CAPD patients, expanding the spectrum of known causative agents.
• The unique antibiotic susceptibility of E. americana requires careful consideration in empiric and targeted therapy.
• This case underscores the importance of microbiological diagnosis and tailored antibiotic selection for CAPD-related peritonitis.