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Ochrobactrum Peritonitis: Case Report and Literature Review
Edward Medeiros1,2, Kevin Tang1,3, Susie Hu1,2
1Department of Internal Medicine, Warren Alpert Medical School, Brown University, Providence, USA.
Abstract:
End-stage kidney disease (ESKD) patients, including those on peritoneal dialysis (PD), are considered immunocompromised and at risk for opportunistic pathogens. Peritonitis is a major infectious PD complication with common causative pathogens, including gram-positive organisms such as coagulase-negative Staphylococcus species, Staphylococcus aureus more often than gram negative organisms. PD peritonitis is often secondary to suboptimal technique leading to contamination of the catheter site but can also be due to bacterial translocation from the bowel lumen or transient bacteremia after procedures; this makes identification of the causative organism crucial to optimal management of PD peritonitis. Ochrobactrum are glucose-non-fermentative, non-fastidious, motile gram-negative bacilli typically isolated in aqueous environments. Reported infections primarily occur in immunocompromised hosts with environmental exposure, including nosocomial contamination of fluids or indwelling catheters. We present only the seventh reported case of Ochrobactrum peritonitis in a 67-year-old PD patient secondary to poor technique, and review the literature for all prior cases. Although there have been no previous cases leading to bacteremia, three of the seven cases required removal of PD catheter.
Insights
Peritoneal dialysis (PD) patients are at risk for infections. This study reports a rare case of Ochrobactrum peritonitis in a PD patient, highlighting the importance of identifying causative organisms for effective treatment.
Area of Science:
- Nephrology
- Infectious Diseases
- Microbiology
Background:
- End-stage kidney disease (ESKD) patients on peritoneal dialysis (PD) are immunocompromised, increasing susceptibility to opportunistic pathogens.
- Peritonitis is a significant complication in PD, commonly caused by gram-positive bacteria, but gram-negative infections also occur.
- Accurate identification of the causative pathogen is critical for managing PD peritonitis effectively.
Observation:
- Ochrobactrum, a gram-negative bacillus found in aqueous environments, can cause infections in immunocompromised individuals.
- This report details the seventh known case of Ochrobactrum peritonitis in a PD patient, linked to suboptimal technique.
- The patient was a 67-year-old undergoing PD.
Findings:
- While Ochrobactrum peritonitis is rare, it poses a risk to PD patients.
- In this case, the infection was attributed to poor PD technique.
- Three out of seven reported Ochrobactrum peritonitis cases necessitated PD catheter removal.
Implications:
- This case underscores the need for vigilance regarding less common pathogens in PD peritonitis.
- Improved PD techniques may help prevent rare infections like Ochrobactrum peritonitis.
- Further research into Ochrobactrum infections in PD patients is warranted to guide clinical management.
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