Kocuria Kristinae Bloodstream Infection in a Catheter-Dependent Haemodialysis Patient with Concurrent Pleural Tuberculosis: A Case Report

Kocuria kristinae is an uncommon bloodstream pathogen in patients with intravascular devices. A 57-year-old man with end-stage kidney disease receiving haemodialysis through a tunnelled left internal jugular catheter presented with dyspnoea, orthopnoea and oedema. Peripheral and central aerobic blood cultures collected on 10 November 2024 grew K. kristinae, identified by matrix-assisted laser desorption ionisation time-of-flight mass spectrometry. The vancomycin minimum inhibitory concentration was 2.0 micrograms/mL, reported as susceptible. Catheter exchange was performed on 12 November and intravenous vancomycin administered. Serial concentrations were 6.06, 4.18, 19.65 and 22.39 mg/L, informing dose adjustment. No repeat blood cultures were obtained after treatment, so microbiological clearance could not be established. Concurrent culture-confirmed pleural tuberculosis required modified therapy because of liver dysfunction. The patient improved clinically and was discharged on 23 November. This case illustrates the importance of evaluating uncommon blood isolates, managing vascular access and individualising antimicrobial dosing in haemodialysis.