National Academy of Agricultural Sciences (NAAS)
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PRINT ISSN : 2319-7692
Online ISSN : 2319-7706 Issues : 12 per year Publisher : Excellent Publishers Email : editorijcmas@gmail.com / submit@ijcmas.com Editor-in-chief: Dr.M.Prakash Index Copernicus ICV 2018: 95.39 NAAS RATING 2020: 5.38 |
Catheter-related bloodstream infections (CRBSIs) are a major cause of morbidity in patients with chronic kidney disease (CKD) undergoing maintenance hemodialysis. We report the case of a 19-year-old female with bilateral grade IV CKD and end-stage renal disease (ESRD) on hemodialysis via a right internal jugular vein (IJV) catheter, who presented with fever, nausea, and vomiting. Blood cultures obtained from the central line and peripheral vein flagged positive with a 2.5-hour differential time to positivity. Gram staining and culture revealed Gram-negative bacilli, later identified by MALDI-TOF MS as Rhizobium radiobacter, an emerging opportunistic pathogen. Antimicrobial susceptibility testing demonstrated susceptibility to cotrimoxazole, fluoroquinolones, cefepime, meropenem, and minocycline, but resistance to ceftazidime and amikacin. The patient was treated with cefoperazone-sulbactam and catheter removal, following which repeat blood cultures were sterile. R. radiobacter, once considered a contaminant, is increasingly recognized as a true pathogen in immunocompromised hosts with indwelling intravascular devices due to its ability to adhere to silicone surfaces. This case highlights the importance of considering R. radiobacter as a potential cause of CRBSI in hemodialysis patients and emphasizes prompt diagnosis, appropriate antibiotic therapy, and catheter removal as critical components of management.
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