A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus kroppenstedtii

Abstract Background Rhodococcus kroppenstedtii is an aerobic, gram-positive bacterium firstly identified in the environment, which has not been reported in human-related infection. Herein, we reported the first case of peritoneal dialysis (PD)-associated peritonitis caused by R. kroppenstedtii which...

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Main Authors: Yi Kang, Yuxin Chen, Zhifeng Zhang, Han Shen, Wanqing Zhou, Chao Wu
Format: Article
Language:English
Published: BMC 2021-06-01
Series:BMC Infectious Diseases
Subjects:
Online Access:https://doi.org/10.1186/s12879-021-06280-8
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spelling doaj-b21d2896f6474d1698c569b1a34df6d62021-06-20T11:07:58ZengBMCBMC Infectious Diseases1471-23342021-06-012111610.1186/s12879-021-06280-8A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus kroppenstedtiiYi Kang0Yuxin Chen1Zhifeng Zhang2Han Shen3Wanqing Zhou4Chao Wu5Department of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical UniversityDepartment of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolDepartment of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolDepartment of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolDepartment of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolDepartment of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical UniversityAbstract Background Rhodococcus kroppenstedtii is an aerobic, gram-positive bacterium firstly identified in the environment, which has not been reported in human-related infection. Herein, we reported the first case of peritoneal dialysis (PD)-associated peritonitis caused by R. kroppenstedtii which was identified by whole genome sequencing. Case presentation A 69-year-old man was admitted to hospital with abdominal pain and fever. Over the last 2 years, he had been undergoing continuous ambulatory peritoneal dialysis (CAPD) due to end-stage renal disease. Clinical symptom and sign in combination with laboratory examinations supported the clinical diagnosis of PD-associated peritonitis. Thus, ceftizoxime and teicoplanin were empirically used after PD effluent was collected for bacterial culture. A gram-positive bacterium was found from the PD effluent culture, which could not be identified by either Vitek 2 Compact ANC card or matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The strain was finally confirmed to be R. kroppenstedtii by whole genome sequencing (WGS) through the average nucleotide identity (ANI) analysis. With a continuous treatment with teicoplanin and imipenem for 15 days and intraperitoneal catheter removed, the infection symptom was improved evidenced by a normal body temperature, also with white blood cell count (WBC), procalcitonin (PCT) and C-reactive protein (CRP) dropped to normal levels. Peritoneal dialysis effluent culture showed a negative result. Then, hemodialysis and arteriovenous fistula angioplasty were performed, but the patient developed a progressive blood pressure loss, accompanied by multiple organ disorder, and died on Feb 25, 2020. Conclusions To the best of our knowledge, this is the first time to report a peritoneal dialysis-associated peritonitis caused by R. kroppenstedtii which was identified by average nucleotide identity analysis based on WGS.https://doi.org/10.1186/s12879-021-06280-8Rhodococcus kroppenstedtiiPeritoneal dialysis-associated peritonitisWhole genome sequencingAverage nucleotide identity
collection DOAJ
language English
format Article
sources DOAJ
author Yi Kang
Yuxin Chen
Zhifeng Zhang
Han Shen
Wanqing Zhou
Chao Wu
spellingShingle Yi Kang
Yuxin Chen
Zhifeng Zhang
Han Shen
Wanqing Zhou
Chao Wu
A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus kroppenstedtii
BMC Infectious Diseases
Rhodococcus kroppenstedtii
Peritoneal dialysis-associated peritonitis
Whole genome sequencing
Average nucleotide identity
author_facet Yi Kang
Yuxin Chen
Zhifeng Zhang
Han Shen
Wanqing Zhou
Chao Wu
author_sort Yi Kang
title A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus kroppenstedtii
title_short A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus kroppenstedtii
title_full A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus kroppenstedtii
title_fullStr A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus kroppenstedtii
title_full_unstemmed A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus kroppenstedtii
title_sort case of peritoneal dialysis-associated peritonitis caused by rhodococcus kroppenstedtii
publisher BMC
series BMC Infectious Diseases
issn 1471-2334
publishDate 2021-06-01
description Abstract Background Rhodococcus kroppenstedtii is an aerobic, gram-positive bacterium firstly identified in the environment, which has not been reported in human-related infection. Herein, we reported the first case of peritoneal dialysis (PD)-associated peritonitis caused by R. kroppenstedtii which was identified by whole genome sequencing. Case presentation A 69-year-old man was admitted to hospital with abdominal pain and fever. Over the last 2 years, he had been undergoing continuous ambulatory peritoneal dialysis (CAPD) due to end-stage renal disease. Clinical symptom and sign in combination with laboratory examinations supported the clinical diagnosis of PD-associated peritonitis. Thus, ceftizoxime and teicoplanin were empirically used after PD effluent was collected for bacterial culture. A gram-positive bacterium was found from the PD effluent culture, which could not be identified by either Vitek 2 Compact ANC card or matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The strain was finally confirmed to be R. kroppenstedtii by whole genome sequencing (WGS) through the average nucleotide identity (ANI) analysis. With a continuous treatment with teicoplanin and imipenem for 15 days and intraperitoneal catheter removed, the infection symptom was improved evidenced by a normal body temperature, also with white blood cell count (WBC), procalcitonin (PCT) and C-reactive protein (CRP) dropped to normal levels. Peritoneal dialysis effluent culture showed a negative result. Then, hemodialysis and arteriovenous fistula angioplasty were performed, but the patient developed a progressive blood pressure loss, accompanied by multiple organ disorder, and died on Feb 25, 2020. Conclusions To the best of our knowledge, this is the first time to report a peritoneal dialysis-associated peritonitis caused by R. kroppenstedtii which was identified by average nucleotide identity analysis based on WGS.
topic Rhodococcus kroppenstedtii
Peritoneal dialysis-associated peritonitis
Whole genome sequencing
Average nucleotide identity
url https://doi.org/10.1186/s12879-021-06280-8
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