Pantoea septica-associated peritoneal dialysis-related peritonitis: first case report

Abstract Background Not only is Pantoea septica primarily recognized as a plant pathogenic bacterium, but it can also cause opportunistic infections in humans. However, cases of peritoneal dialysis (PD)-related peritonitis caused by P. septica have not been reported. Case presentation The patient was a man in his 50s with chronic kidney disease secondary to chronic glomerulonephritis. Hemodialysis was initiated 22 years earlier, followed by kidney transplantation 15 years ago. After graft loss, he resumed hemodialysis 8 years ago. The patient desired a transition to PD, which was initiated 1 month prior to admission. In the 2 days before admission, he developed abdominal pain accompanied by cloudy PD effluent and presented to the emergency department. Analysis of the PD effluent revealed a cell count of 6500/μL (neutrophils 84.2%), which led to a diagnosis of PD-related peritonitis. He was urgently admitted, and P. septica was isolated from the effluent culture. Treatment with ceftriaxone, to which the organism was susceptible, resulted in clinical improvement. After 3 weeks of antibiotic therapy, the patient was discharged. Conclusions P. septica belongs to the Enterobacteriaceae family but is not part of the normal human intestinal flora. It is widely distributed in the environment, including soil and plants. Therefore, contact contamination during bag exchange is a likely route of infection. This case highlights the importance of recognizing that PD-related peritonitis may occur via catheter-related contamination following contact with soil or plants.