# Catheter-Related Bloodstream Infection with Rhizobium radiobacter and Pseudomonas oryzihabitans Co-Infection: A Case Report and Literature Review

## TL;DR

A rare case of bloodstream infection caused by two uncommon environmental bacteria is reported, emphasizing their potential to cause serious illness in vulnerable patients.

## Contribution

First reported case of co-infection with Rhizobium radiobacter and Pseudomonas oryzihabitans in a catheter-related bloodstream infection.

## Key findings

- The patient had occupational exposure to soil and moisture, likely contributing to the infection.
- Rhizobium radiobacter and Pseudomonas oryzihabitans can cause life-threatening bacteremia despite being considered contaminants.
- The case highlights the importance of considering environmental and occupational factors in diagnosing unusual pathogens.

## Abstract

Background: Catheter-related bloodstream infections (CRBSIs) caused by environmental organisms are uncommon, and polymicrobial cases are even rarer. Methods: We describe the first case of catheter-related bloodstream infection caused by two infrequent environmental organisms—Rhizobium radiobacter and Pseudomonas oryzihabitans—occurring as a co-infection. Results: The patient’s occupation involved frequent exposure to moist, soil-contaminated environments. Although these bacteria are often considered contaminants, they are capable of causing invasive infections such as bacteremia, which can be life-threatening. Conclusions: This case underscores the emerging pathogenic potential of R. radiobacter and P. oryzihabitans co-infection, particularly in patients with underlying malignancies or end-stage renal disease who have indwelling vascular devices, and highlights the importance of considering occupational and environmental exposures in the differential diagnosis of unusual pathogens.