Paracoccus yeei peritonitis in peritoneal dialysis

Opportunistic peritonitis in peritoneal dialysis: The example of Paracoccus yeei

Paracoccus yeei, a Gram-negative coccobacillus, is an emergent opportunistic pathogen. It originates from soil and water. VITEK and MALDI-TOF are used for identification. There are few reports of peritoneal dialysis peritonitis. Its presentation is usually indolent. It can be successfully treated with several antibiotics: β-lactams, aminoglycosides, without removing the catheter.

Paracoccus yeei as a cause of peritoneal dialysis peritonitis in the United Kingdom

Introduction

Paracoccus yeei is a Gram-negative coccobacilli which is often an environmental organism. However, infection of patients usually with underlying immunosuppression has been described in the last decades, mainly due to the emergence of diagnostic molecular methods.

Case presentation

We describe here a case of P. yeei peritonitis in a patient undergoing peritoneal dialysis. Turbidity of the peritoneal dialysate was the sole clinical manifestation. Inflammatory markers were not raised. A peritoneal fluid specimen showed increased white-cell count, but no organisms were seen on Gram stain. MALDI-TOF mass spectrometry identified P. yeei as the infectious agent. Patient was successfully treated with gentamicin. Minimum inhibitory concentration analysis suggested P. yeei to be sensitive to aminoglycosides and specific betalactams but not to ciprofloxacin and ceftazidime, in line with previous literature.

Discussion

This case of P. yeei peritoneal-dialysis peritonitis contributes to accumulating evidence on the emergent role of this organism as a relevant human pathogen. It also provides information about antibiotic resistance patterns that helps to guide therapy more specifically and effectively.