Beyond Bioremediation: A Rare Case of Comamonas testosteroni Bloodstream Infection in a Patient With Stage 5 Chronic Kidney Disease on Maintenance Hemodialysis.

Abstract

Comamonas testosteroni is a gram-negative aerobic bacillus commonly found in environmental sources and known for its bioremediation potential. Although it is widely distributed in nature, human infection is rare, but it is increasingly being recognized as a nosocomial pathogen. A 68-year-old female with stage 5 chronic kidney disease (CKD V) on maintenance hemodialysis since 2017 presented with fever and decreased consciousness. On examination, a tunneled cuffed catheter (TCC) was noted in the right internal jugular vein. Two sets of blood cultures, one drawn from the TCC and the other from a peripheral vein, grew C. testosteroni after 48 h. The organism was identified using API ID strips and was sensitive to amikacin, gentamicin, ceftazidime, imipenem, and meropenem but resistant to ciprofloxacin. She was treated with catheter removal and intravenous ceftazidime. The patient recovered completely after 5 days of hospitalization, with resolution of fever and improved consciousness. This case highlights C. testosteroni as an emerging nosocomial pathogen in immunocompromised patients undergoing invasive procedures. It underscores the importance of vigilant surveillance and strict catheter management protocols.