Genetically Confirmed Edwardsiella tarda Peritonitis was Associated with Improper Caregiver's Hand Hygiene during Peritoneal Dialysis Bag Exchange

Edwardsiella tarda is a Gram-negative bacillus and is responsible for waterborne disease. This is the first case report of peritoneal dialysis (PD)-associated peritonitis caused by genetically confirmed E. tarda, which was transmitted from the caregiver's hand during PD bag exchange. Aside from that, the caregiver was a fishmonger and a gastrointestinal carrier of the pathogen. Prior to the onset of peritonitis, the caregiver reported that she did not wash her hands every time when performing the PD bag exchange. Although extraintestinal edwardsiellosis usually poses a poor outcome, PD-associated peritonitis with this species is paradoxical if diagnosed early, and treatment is promptly provided, as presented here. This case emphasizes the importance of hand hygiene in preventing environment-bound infection in patients on PD and demonstrates the unusual route of infection, contamination during PD bag exchange.