Staphylococcus cohnii infection diagnosed by metagenomic next generation sequencing in a patient on hemodialysis with cirrhotic ascites: a case report

Front Cell Infect Microbiol. 2023 Sep 22:13:1240283. doi: 10.3389/fcimb.2023.1240283. eCollection 2023.

Abstract

Background: Patients with spontaneous bacterial peritonitis (SBP) often just receive empirical antibiotic therapy, as pathogens can be identified in only few patients using the techniques of conventional culture. Metagenomic next generation sequencing (mNGS) is a useful tool for diagnosis of infectious diseases. However, clinical application of mNGS in diagnosis of infected ascites of cirrhotic patients is rarely reported.

Case presentation: A 53-year-old male with cirrhosis on regular hemodialysis presented with continuous abdominal pain. After treatment with empiric antibiotics, his inflammatory parameters decreased without significant relief of abdominal pain. Finally, based on ascites mNGS detection, he was diagnosed as infection of Staphylococcus cohnii (S.cohnii), a gram-positive opportunistic pathogen. With targeted antibiotic treatment, the bacterial peritonitis was greatly improved and the patient's abdominal pain was significantly alleviated.

Conclusions: When conventional laboratory diagnostic methods and empirical antibiotic therapy fail, proper application of mNGS can help identify pathogens and significantly improve prognosis and patients' symptoms.

Keywords: Staphylococcus cohnii (S.cohnii); ascites; hemodialysis; metagenomic next generation sequencing (mNGS); spontaneous bacterial peritonitis (SBP).

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Pain / drug therapy
  • Anti-Bacterial Agents / therapeutic use
  • Ascites / diagnosis
  • Ascites / microbiology
  • High-Throughput Nucleotide Sequencing / methods
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis
  • Male
  • Metagenomics / methods
  • Middle Aged
  • Peritonitis* / diagnosis
  • Peritonitis* / microbiology
  • Sensitivity and Specificity
  • Staphylococcal Infections* / diagnosis
  • Staphylococcal Infections* / drug therapy

Substances

  • Anti-Bacterial Agents

Supplementary concepts

  • Staphylococcus cohnii

Grants and funding

The work was supported by grants from the National Natural Science Foundation of China (No. 81974071 and No. 82270558).