Refractory Peritoneal Dialysis Peritonitis Due to Neisseria macacae: A Case Report and Review of the Literature

Peritoneal dialysis-associated peritonitis caused by Neisseria.sicca: A case report and literature review

Neisseria sicca, a Gram-negative diplococcus commonly found in the nasopharynx as part of normal bacterial flora, is typically non-pathogenic but has been associated with various diseases including endocarditis, conjunctivitis, pneumonia and meningitis (Jeurissen et al., 2006; Kozlova et al., 2020; Alcid, 1980; Carter et al., 2007). In this report, we present a case of peritonitis in a patient undergoing peritoneal dialysis caused by N. sicca and review the literature on Neisseria-associated peritonitis.

Neisseria elongata-mediated peritonitis in an end-stage renal disease patient on automated peritoneal dialysis: a case report and literature review

Peritoneal dialysis (PD) can result in peritonitis, which frequently causes severe and near-fatal clinical implications if left untreated. Usually, gram-positive bacteria are the most common organisms involved. Uncommonly recognized as the cause of peritonitis in PD patients, Neisseria elongata is a gram-negative nasal and oropharyngeal normal flora organism.

Case presentation

We report a rare case of a 29-year-old man who had received automated PD for 6 years and had N. elongata peritonitis.

Discussion

Several case reports of Neisseria-related peritonitis may point to the potential pathogenicity of such organisms and suggest that many cases of culture-negative peritonitis may have been misdiagnosed. Poor nutrition and chronic kidney disease have been suggested as potential risk factors for N. elongata peritonitis, both of which are present in our patient. With appropriate antibiotic use, most of the cases respond well to empirical treatment.

Conclusion

Although rare, N. elongata can lead to PD catheter. peritonitis that, in some cases, require changing to hemodialysis.

Neisseria elongata -mediated peritonitis in an end-stage renal disease patient on automated peritoneal dialysis, A case report and literature review

Introduction

Peritoneal dialysis (PD) can result in peritonitis, which frequently causes severe and near-fatal clinical implications if left untreated. Usually, Gram-positive bacteria are the most common organisms involved. Uncommonly recognized as the cause of peritonitis in PD patients, Neisseria Elongata is a gram-negative nasal and oropharyngeal normal flora organism.

Case presentation

We report a rare case of a 29-year-old man who had received automated peritoneal dialysis for six years and had Neisseria Elongata peritonitis.

Discussion

Several case Reports of niseria-related peritonitis may point to the potential pathogenicity of such organisms and suggest that many cases of culture-negative peritonitis may have been misdiagnosed. Poor nutrition and chronic kidney disease have been suggested as potential risk factors for Neisseria elongata peritonitis [8], both of which are present in our patient. With appropriate antibiotic use, most of the cases respond well to empirical treatment.

Conclusion

Although rare, Neisseria Elongata can lead to Peritoneal Dialysis catheter Peritonitis that, in some cases, require changing to hemodialysis.

Genomic sequence of the non-pathogen Neisseria sp. strain MA1-1 with antibiotic resistance and virulence factors isolated from a head and neck cancer patient

Recent research has claimed virulence factors or antimicrobial resistance in commensal or non-pathogenic Neisseria spp. This study aimed to isolate and analyze commensal microorganisms related to the genus Neisseria from the oral cavity of a patient with head and neck cancer. We successfully isolated strain MA1-1 and identified its functional gene contents. Although strain MA1-1 was related to Neisseria flava based on 16S rRNA gene sequence similarity, genomic relatedness analysis revealed that strain MA1-1 was closely related to Neisseria mucosa, reported as a commensal Neisseria species. The strain MA1-1 genome harbored genes for microaerobic respiration and the complete core metabolic pathway with few transporters for nutrients. A number of genes have been associated with virulence factors and resistance to various antibiotics. In addition, the comparative genomic analysis showed that most genes identified in the strain MA1-1 were shared with other Neisseria spp. including two well-known pathogens, Neisseria gonorrhoeae and Neisseria meningitidis. This indicates that the gene content of intra-members of the genus Neisseria has been evolutionarily conserved and is stable, with no gene recombination with other microbes in the host. Finally, this study provides more fundamental interpretations for the complete gene sequence of commensal Neisseria spp. and will contribute to advancing public health knowledge.

Neisseria macacae bacteremia: report of two cases with a literature review

Background

Neisseria macacae was discovered in the oral cavity of monkeys in 1983. In humans, it has been isolated from the upper respiratory tract of neutropenic patients. However, only two cases of N. macacae bacteremia have been reported in a 65-year-old man with infective endocarditis and a 5-month-old child with fever and petechiae. There are no reports of infections in cancer patients. Here, we present two cases of N. macacae bacteremia in cancer patients.

Case presentation

In the first case, a 42-year-old woman who underwent ovarian cancer surgery presented with duodenal invasion associated with multiple lymph node metastasis. N. macacae was isolated from her blood culture and identified using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry (MS). In the second case, a 69-year-old woman with a long-standing history of esophagogastric junction cancer presented with fever. She had stage IVB cancer with lung, bone, and multiple lymph node metastasis. The last chemotherapy was administered 5 weeks before N. macacae was detected using MALDI-TOF MS and nitrate test negative. In both cases, transthoracic echography showed no vegetation. Antibiotics were administered for 14 and 13 days in the first and second cases, respectively. In both cases, fever alleviated on day 4 of antibiotic administration. Both patients were discharged after their conditions improved.

Conclusions

This, to our knowledge, is the first report of N. macacae bacteremia in cancer patients. Both patients, mucosal damage was observed in the upper gastrointestinal tract. Therefore, exclusion diagnosis suggested that bacteremia invasion was caused by mucosal rupture in both cases. Both cases responded well to treatment with β-lactam antibiotics and improved after 2 weeks. Modifying the treatment based on the source of the infection may shorten the treatment period. Therefore, further research on N. macacae bacteremia is necessary. Immunocompromised patients such as those with cancer are susceptible to mucosal damage by unusual bacterial species such as N. macacae despite not having contact with monkeys.