A Case of Roseomonas gilardii Peritonitis Associated with a Flooded Peritoneal Dialysis Treatment Space.

Bacterial peritonitis is a key complication of Peritoneal Dialysis (PD) and a preventable cause of withdrawal from PD treatment. Infection generally arises from contamination with skin commensals during handling of the dialysis delivery system or from translocation of gastrointestinal organisms and more rarely from an environmental organism. Herein, we report the case of a 73-year-old admitted for PD-related peritonitis due to Roseomonas gilardii with an associated environmental exposure from a domestic plumbing issue. We describe the presentation, case, and antibiotic regimen progression from empiric therapy of ceftazidime and vancomycin IP to ciprofloxacin. We acknowledge the importance of performing laboratory sensitivities given the high antibiotic resistance of the Roseomonas genus. We offer that nephrologists should consider Roseomonas as a potential causative organism of peritonitis, especially when initial or further history reveals exposure to potentially contaminated water.

Peritonitis caused by Roseomonas mucosa after ventriculoperitoneal shunt revision: a case report.

Ventriculoperitoneal shunt (VPS) is an adequate treatment for congenital hydrocephalus or chronic hydrocephalus in adults. Yet, it is a surgery associated with a significant rate of complications amongst neurosurgical procedures, with frequent shunt obstructions and infections. We report the first-ever case of peritonitis caused by Roseomonas mucosa, shortly after the revision of a VPS ventricular catheter. Hardware removal and proper antibiotic therapy led to the patient's recovery. Roseomonas mucosa is an opportunistic skin pathogen with an antibiotic resistance profile to many beta-lactamines and a tropism for indwelling catheters and post-operative period. Nowadays, it should be taken into account in case of infection of indwelling catheters and for some implantable medical devices.

Differing Virulence of Healthy Skin Commensals in Mouse Models of Infection.

Introduction: As therapies for atopic dermatitis (AD) based on live biotherapeutic products (LBP) are developed, the potential displacement of biotherapeutic strains, and species to mucosal sites where they are not naturally found is of investigative interest. However, formal assessment of the toxicity potential of healthy skin commensal organisms has not been reported in the literature. Our previous research indicates that topical application of live Roseomonas mucosa to treat AD was associated with clinical benefit on the skin, but the effects of exposure via inhalation, eye inoculation, and ingestion were unknown. Methods: Herein we report our findings from mice inoculated with commensal strains of R. mucosa, coagulase negative Staphylococci (CNS), and Pseudomonas aeruginosa. Bacterial isolates were collected under clinical trial NCT03018275, however these results do not represent an interventional clinical trial. Results: Our tested R. mucosa isolates did not display significant infection or inflammation. However, neutropenic mice inoculated with CNS had infection without major inflammation in pulmonary models. In contrast, systemic infection generated hepatic and splenic pathology for P. aeruginosa and CNS, which was worsened by the presence of neutropenia. Discussion: Our results suggest that LBP derived from bacteria without significant infectivity histories, such as R. mucosa, may represent safer options than known pathobionts like P. aeruginosa and Staphylococcus spp. Overall, these results suggest that topically applied LBP from select skin commensals are likely to present safe therapeutic options and reinforce our prior clinical findings.

Peritonitis caused by Roseomonas in a patient undergoing automated peritoneal dialysis: case report and literature review.

A 48-year-old man was admitted with cloudy dialysate and diagnosed as peritoneal dialysis (PD)-related peritonitis caused by Roseomonas infection. This is the third case of PD-related peritonitis due to Roseomonas species and also the first case of peritonitis in automated peritoneal dialysis. Despite its low virulence and rare incidence in peritoneal dialysis, clinicians should be alert to the possibility of Roseomonas infection due to its high resistance to antibiotics. Literature on Roseomonas infection is also reviewed. The current guidelines for empirical peritonitis in PD patients do not adequately cover such infection. Refractory treatment in high risk cases should alert clinicians to upgrade antibiotics even for a vague manifestation.