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Review
. 2020 Mar 19;21(1):102.
doi: 10.1186/s12882-020-01765-1.

Pet-related Pasteurella multocida induced peritonitis in peritoneal dialysis: a case report and review of the literatures

Haoran Mu  1 , Man Yang  2 , Yueyue Zhang  2 , Yajing Zhang  1 , Juan Wang  2 , Weijie Yuan  2 , Shu Rong  3
Affiliations
Review

Pet-related Pasteurella multocida induced peritonitis in peritoneal dialysis: a case report and review of the literatures

Haoran Mu et al. BMC Nephrol. .

Abstract

Background: P. multocida (Pasteurella multocida) is animal-sourced gram-negative coccobacillus which can be transmitted to human through many animals including household pets. P. multocida induced peritoneal dialysis-related peritonitis has rarely been reported. In recent years, there has been an increase in the incidence of P. multocida induced peritoneal dialysis-related peritonitis, for the reason that patients with PD at home bred household pets. In this study, we present a case of a P. multocida induced peritoneal dialysis-related peritonitis, which is suspected to be caused through intimate contact with a household cat and we have reviewed 28 cases reported before and give suggestions for treatment and the way of prevention.

Case presentation: A 75-year-old man with end-stage renal disease (ESRD) for nearly 5 years on continuous ambulatory peritoneal dialysis (CAPD) was admitted to the nephrology department with a 1-week history of abdominal pain and a cloudy peritoneal dialysis effluent. Based on the history, physical examination and laboratory results with the findings in the peritoneal dialysis fluid, a diagnosis of peritoneal dialysis-related peritonitis was confirmed. The final culture of initial peritoneal effluent results indicated the organism was P. multocida. After a 12-day antibiotic treatment, the condition of patient was not improved. The patient was switched to ampicillin/sulbactam (3 g intravenously) twice every day and the condition was improved significantly. On further inquiring, the patient reported that he had had a cat at home and when the patient did CAPD, the cat was usually playing with the tubing or contacting the patient during CAPD.

Conclusion: In our case and reviewed cases, P. multocida induced peritoneal dialysis-related peritonitis could be cured by proper antibiotic treatment. If individuals keep the pet away from the PD process, the infection route may be severed. P. multocida induced peritoneal dialysis-related peritonitis does not need catheter removal and exchange with hemodialysis except long-time intractable peritonitis.

Keywords: Cat; Pasteurella multocida; Peritoneal dialysis; Peritonitis; Pet.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The character of PD effluent. a The effluent collected on the day of admission. b The effluent collected to compare on the day of discharge. c Antibiotic treatment after hospital admission. At the early stage of treatment, we tried different types of antibiotics according drug sensation test. However, the effectiveness was not satisfied. After using ampicillin/sulbactam intravenously on Aug. 30th, the WBC count in PD effluent went down and the volume of the effluent went up, indicating an effective treatment. During the treatment, the patient had a period of temporary hemodialysis from the 13th day after admission to the day that WBC count of PD effluent was normal stably after 12 days ampicillin/sulbactam treatment. HD: hemodialysis, DC: discharge
Fig. 2
Fig. 2
1.Three main risk factors in reviewed cases. a When PD machine is not used, the suspected pet plays or rests near the machine transmit the bacteria to the machine. b When patient is using the PD machine or is going to use it, the catheter is found to be bit by household pet. c When using the PD machine, the patient had intimate contact with the pet. 2.Manual PD approach in this case. d The patient was under PD without an infection by suspected pet or other factors. e During manual PD, the patient might infect the tube or dialysate after contacting a suspected pet who carried bacteria in process of filling, dwelling and draining. For the next time of PD, the bacteria went into the abdomen and caused peritoneal infection
Fig. 3
Fig. 3
Drug sensitive test results of the reviewed cases. The horizontal coordinate is the antibiotics involved and the vertical coordinate is the reviewed cases which have done the valuable drug sensitive tests. formula image The green tube represents the bacteria is sensitive to the antibiotic. formula image The yellow tube represents the sensibility is unknown. formula image The red tube represents the bacteria is resistant to the antibiotic
See this image and copyright information in PMC

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