I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on October 11, 2010, 12:26:33 PM
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Peritoneal dialysis infections and pets
Posted on October 10, 2010 by Scott Weese
Pasteurella multocida is a bacterium that can be commonly found in various pet species. It is typically an inhabitant of the upper respiratory tract of healthy pets, although it is an important cause of respiratory disease in rabbits (snuffles). It is also a zoonotic pathogen, and human infections are sporadically reported. Most are associated with bites, mainly cat bites. Others have involved pets licking wounds or broken skin. Infections seem to be a particular concern in people undergoing dialysis because of kidney failure. Infections have been associated with things like cats chewing on dialysis tubing and pets having contact with catheter sites.
A recent report described another dialysis-associated infection in person with chronic kidney disease and diabetes (Satomura et al Ther Apher Dial 2010). The person developed peritoneal dialysis-associated peritonitis. That is infection of the internal lining of the abdominal cavity (the space between the intestines/other abdominal organs and the body wall) associated with peritoneal dialysis. For peritoneal dialysis, a catheter is left in place through the body wall, into this cavity. Infections can occur from bacteria migrating through or along the catheter and into the peritoneal cavity. In this case, Pasteurella multocida was isolated from infected peritoneal fluid. A source of infection wasn’t clear, and no obvious risk factors like a cat gnawing on the catheter were reported. However, the same bacterium was isolated from a throat swab taken from the person’s cat. Given how common this bacterium is in cats, how uncommon it is in people and previous reports of cat-associated infection, it’s logical to assume that the cat was the source.
The fact that no clear risk factors were identified in this case highlights the ever-present (but still relatively low) risk to people with dialysis catheters and cats. Certain things like keeping the cat away from the catheter site and other dialysis items are common sense and presumably very important. However, general hygiene measures are also probably very important. It is logical that a cat owner could frequently get this bacterium on their hands from regular interaction with the cat, or potential from contact with sites like food and water bowls. Good attention to hand hygiene, especially before touching the catheter or any dialysis items, must not be overlooked, and should be an important part of counseling of dialysis patients that own pets. Unfortunately, the risks associated with pets are not always discussed by physicians (who may not even ask about pet ownership), so some people don’t get the required information.
Note: Image is from http://www.kidney.org.uk/kids/crf/page09.html It's presumably meant to be a cute image showing a happy and healthy kid. It's interesting that they show a cat in the picture but no where on the page is there any mention about infection control measures that should be taken. It seems like a missed education opportunity to me.
Tags: Cats, pasteurella multocida, perintonitis, peritoneal dialysis
http://www.wormsandgermsblog.com/2010/10/articles/animals/cats/peritoneal-dialysis-infections-and-pets/