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Abstract: PO1318

Ochrobactrum Peritonitis in Peritoneal Dialysis: A Rare Case and Literature Review

Session Information

Category: Trainee Case Report

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Medeiros, Edward G., Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
  • Juarez, Lubin, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
  • Hu, Susie L., Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
  • Shah, Ankur, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
Introduction

Ochrobactrum are glucose-non-fermentative, non-fastidious, motile gram-negative bacilli typically isolated in aqueous environments. Reported infections by this pathogen primarily occur in immunocompromised hosts from environmental exposure, nosocomial contamination of sterile fluids and/or indwelling catheter use. Due to impaired immunity and exposure to exogenous microbes, peritonitis is a common and feared complication of peritoneal dialysis. We present a case of Ochrobactrum Anthropi peritonitis and review the literature of similar case.

Case Description

A 67-year-old male with history of ESRD secondary to IgA nephropathy on CCPD for 4 years presented to the hospital with fevers, nausea, abdominal pain and generalized weakness. He experienced an episode of acute bacterial peritonitis 1-month prior to this hospitalization secondary to Pseudomonas aeruginosa treated with ciprofloxacin and no other previous PD complications. A peritoneal effluent sample showed 347 nucleated white blood cells. He was empirically initiated on intraperitoneal cefepime and vancomycin, as well as oral fluconazole for fungal prophylaxis. Peritoneal effluent culture grew Orchrobactrum anthropi, sensitive to fluoroquinolones and carbapenems but resistant to cefepime. Antimicrobials were subsequently transitioned to ciprofloxacin and fluconazole, and he completed the antibiotic course with resolution of symptoms and peritoneal leukocytosis.

Discussion

We present the 8th case of Ochrobactrum Anthropi peritonitis in a peritoneal dialysis patient. Zero of the published cases were associated with bacteremia. Attempted treatments have typically included carbapenems, aminoglycosides, and fluoroquinolones. Three of eight cases required removal of the tenkhoff catheter. Peritonitis related mortality was zero percent. This case and review of the literature can serve to inform future occurrences.