From inference to proof: nanopore sequencing confirms zoonotic Neisseria Zoodegmatis peritonitis after cat bite-related contamination in a patient on automated peritoneal dialysis.
Nattapat Anuduang, Talerngsak Kanjanabuch, Piyaporn Towannang et al.
✦ AI-curated · Sources linked
Case in brief
A 90-year-old patient receiving automated peritoneal dialysis developed peritonitis after a cat bite damaged the transfer set. Empirical therapy produced only a partial response, followed by relapse. Culture and MALDI-TOF identified Neisseria zoodegmatis, with identification confirmed by 16S rRNA sequencing of isolates and dialysis effluent. Intermediate β-lactam susceptibility led to carbapenem-based therapy. Nanopore sequencing found N. zoodegmatis dominant in the effluent and the same species in the cat’s saliva. Sustained remission followed strict environmental control.
What made this case unusual
Nanopore sequencing demonstrated molecular concordance between the organism in the patient’s dialysis effluent and the cat’s saliva, providing molecular evidence of zoonotic transmission.
Diagnostic / clinical pearl
In relapsing peritoneal dialysis peritonitis with suspected pet-related contamination, reassess antimicrobial susceptibility and consider long-read sequencing when conventional testing does not resolve the diagnostic question.
Why it matters
The case illustrates that environmental control may be needed alongside antimicrobial therapy to achieve sustained remission after pet-related contamination.