Agrobacteriumradiobacterperitonitis in a patient on continuous ambulatory peritoneal dialysis
Abstract number: 1134_03_170
Konstantakopoulou-Papadaki H., Botsari S., Sonician M., Vlasopoulos D., Kouppari G.
The presentation of Agrobacteriumradiobacter peritonitis in an adult under continuous ambulatory peritoneal dialysis (CAPD).
Peritoneal fluid specimens were examined for cells count and were cultured in Bactec Plus culture vials (Bactec plus, Becton Dickinson). After centrifugation the specimen was also cultured on appropriate media for aerobic and anaerobic microorganisms and smears were performed by Gram stain. The identification of bacterium was carried out by standard methods and API-32E, API 32GN (bioMerieux). The susceptibility testing was performed by disk diffusion method.
A male patient aged 87 years, at final stage of renal failure under CAPD for 15 months and deficient renal function, was admitted to hospital because of the appearance of a cloudy peritoneal dialysate effluent and nausea. The patient had a history of three episodes of peritonitis caused by Gram negative bacteria (Klebsiellapneumoniae and Pseudomonasaeruginosa, Flavomonasoryzihabitans, Acinetobacterjohnsonii). The patient was successfully treated with IP tobramycin and recovered completely. On day of admission the peritoneal analysis showed 3100 WBC/ìl (96% neutrophills). The patient was treated empirically with IP tobramycin. Forty eight hours after the incubation of peritoneal fluid gram negative bacterium was isolated. Tests for oxidase and catalase were positive. The hydrolysis test of esculine was positive. The bacterium was identified as Agrobacteriumradiobacter. The bacterium was susceptible to cefuroxime, ceftriaxone, ciprofloxacin, imipenem, tetracycline and gentamicin and resistant to ampicillin, trimethoprime-sulfamethoxazole, cephalothin and tobramycin. The patient was treated with cefuroxime 750mgx3 IP for three weeks and he recovered completely.
Agrobacteriumradiobacter is a microorganism found in the environment and more particularly in several kinds of soils and is considered a plant pathogen. In rare cases of immunocompromised patients and especially for patients with transcutaneous catheters or implanted biomedical protheses, Agrobacteriumradiobacter has been regarded as the cause of bacteramia and peritonitis.
|Session name:||XXIst ISTH Congress|
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