Kocuria Rhizophila peritonitis in peritoneal dialysis: About 2 cases and review of the literature

Abstract

Summary

The authors report two clinical cases of peritonitis caused by Kocuria rhizophila, an uncommon but pathogenic bacterium, that occurred in a dialysis center over a three-month period in 2022. These cases required removal of the peritoneal dialysis catheter, illustrating the potential severity of these infections. The authors describe the clinicobiologic features of these peritonitis and highlight the difficulty in distinguishing Kocuria from other gram-positive cocci, such as staphylococci, due to their morphologic similarity and the need for accurate identification for appropriate treatment.

The discussion focuses on the incidence and management of Kocuria peritonitis in France, based on an observational cohort study using data from the Registre de Dialyse Péritonéale de Langue Française (RDPLF) between January 2018 and May 2023. The study found that Kocuria peritonitis accounted for 3.5% of documented peritonitis, with Kocuria rhizophila being the most commonly identified. The study highlights a high recurrence rate and the frequent need for catheter removal, underscoring the severity of these infections.

Conclusion: The authors suggest that rapid catheter removal and replacement should be considered in cases of Kocuria rhizophila peritonitis, given the high rate of relapse. They also call for increased vigilance and close follow-up of patients treated conservatively with antibiotics to minimize the risk of relpase and technical failure, suggesting the need for therapeutic strategies tailored to this specific pathogen.