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Abstract: PO0983

A Case of Abdominal Wall Abscess Caused by Aeromonas hydrophila in Prior Peritoneal Catheter Site in an Immunocompromised Patient Post Kidney Transplant

Session Information

  • Peritoneal Dialysis
    November 04, 2021 | Location: On-Demand, Virtual Only
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Trilleras Gomez, Angelica P., Holy Cross Hospital, Ft Lauderdale, Florida, United States
  • Antony, Maya, University of Miami School of Medicine, Miami, Florida, United States
  • Waheed, Ahmed A., Holy Cross Hospital Department of Nephrology, Ft Lauderdale, Florida, United States
Introduction

Aeromonas hydrophila is a gram-negative rod-shaped bacterium found in aquatic ecosystems; it has been identified as the causative organism of different opportunistic infections in the immunocompromised and there is growing evidence of infection in the immunocompetent. This pathogen has been implicated in acute gastroenteritis, soft tissue infections, meningitis, peritonitis and sepsis among others.

Case Description

We report a case of a 56 year old woman with end stage kidney disease previously on peritoneal dialysis (PD) with subsequent live donor kidney transplant on immunosuppression, who presented with right lower quadrant abdominal cellulitis and deep abscess around the catheter site. Post transplant, her PD catheter was removed, however, the catheter site never healed completely. Although she did have multiple superficial skin infections in the past, those resolved with antibiotics. But this specific cellulitis, did not improve despite multiple antibiotic regimens, and further imaging studies revealed she had developed an abscess. The abscess was managed by surgical incision and drainage with debridement of the skin, subcutaneous tissue, fascia, and muscles around the whole catheter tract. Aeromonas hydrophila was found as the causative organism.

Discussion

To our knowledge, this is the first case of an A. hydrophila abscess associated with a peritoneal dialysis catheter. Firm association between aeromonads and the use of intravenous indwelling devices has already been demonstrated. We hypothesize that her deep seeded infection could be associated with the intrinsic ability of A. hydrophila to form biofilms upon detecting a suitable surface, making them more virulent. The formation of biofilm has been associated with exponential growth as the source of pathogenicity of this bacteria in pisciculture studies. This characteristic could be one of the factors contributing to reported cases of peritonitis and intravenous hemodialysis catheters by A. hydrophila. Further elucidation of A. hydrophila virulence factors in humans can provide insight on prevention of PD catheter associated infections by A. hydrophila.