Infectious Disease Reports最新文献

{"title":"Vasculonecrotic Reaction Caused by Mycobacterium Lepromatosis Infection-A Case Report of an HIV/Leprosy-Coinfected Patient.","authors":"Fernando Amador-Lara, Jorge L Mayorga-Garibaldi, Felipe J Bustos-Rodríguez, Luz A González-Hernández, Pedro Martínez-Ayala, Jaime F Andrade-Villanueva","doi":"10.3390/idr17030058","DOIUrl":"10.3390/idr17030058","url":null,"abstract":"<p><strong>Background: </strong>Vasculonecrotic reactions in leprosy are typically associated with type 2 reactions. Differentiating between necrotizing erythema nodosum leprosum (nENL) and Lucio's phenomenon (LP) can be difficult, as overlapping clinical and histopathological features have been reported. <i>Mycobacterium lepromatosis</i>, a recently identified species causing leprosy, has been sporadically linked to LP. While type 1 reactions are more commonly observed in HIV-coinfected individuals, reports of LP or ENL occurring outside the context of immune reconstitution inflammatory syndrome (IRIS) remain rare.</p><p><strong>Methods: </strong>We report a case of a vasculonecrotic leprosy reaction due to <i>M. lepromatosis</i> in an antiretroviral-naive patient with advanced HIV infection.</p><p><strong>Results: </strong>The patient presented with a two-month history of papules and nodules that progressed to painful necrotic ulcers, accompanied by systemic symptoms. Clinically, the presentation was consistent with nENL; however, histopathological analysis supported a diagnosis of LP. The patient rapidly deteriorated, developing septic shock and dying shortly thereafter. To our knowledge, this is the first reported case of a leprosy-associated vasculonecrotic reaction caused by <i>M. lepromatosis</i> in an HIV-infected individual not associated with IRIS.</p><p><strong>Conclusions: </strong>Vasculonecrotic reactions in leprosy are life-threatening emergencies due to their potential for rapid clinical deterioration and sepsis. In individuals with advanced HIV infection, recognition of these reactions may be challenging, as they can mimic other opportunistic infections, including fungal diseases, malignant syphilis, and disseminated mycobacterial infections. Early identification and prompt treatment are critical to improving outcomes.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial, Social and Serological Factors in the Prevalence and Risk of Leprosy in Areas of High Endemicity: An Integrative Review.","authors":"Daniele Dos Santos Lages, Isabela Cristina Lana Maciel, Sarah Lamas Vidal, Francisco Carlos Félix Lana","doi":"10.3390/idr17030057","DOIUrl":"10.3390/idr17030057","url":null,"abstract":"<p><strong>Background/objectives: </strong>Leprosy remains a global public health challenge, especially in hyperendemic areas, where spatial, socioeconomic and serological factors influence its persistence. In this study, an integrative review was carried out to analyze the relationship between these factors and the prevalence of <i>Mycobacterium leprae</i> infection, as well as the risk of falling ill.</p><p><strong>Methods: </strong>The integrative search was conducted in the BVS (Medline and LILACS) and Scopus databases, including studies published between 2010 and 2024; PRISMA was followed.</p><p><strong>Results: </strong>The findings indicate that spatial analysis, using geographic information systems, is essential for identifying transmission clusters and targeting control strategies. Poor socioeconomic conditions, such as low income and inadequate sanitation, significantly increase the risk of infection. In addition, serology, especially the detection of Anti-PGL-1 antibodies, has proved to be a promising tool for tracking subclinical infections and improving epidemiological surveillance. However, the integration of spatial, social and serological factors is still limited in the literature.</p><p><strong>Conclusions: </strong>We conclude that multidisciplinary approaches, combining spatial, socioeconomic and serological factors, are fundamental to optimizing control strategies and reducing leprosy transmission in vulnerable populations.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID: A Systematic Review of Preventive Strategies.","authors":"Sun O Park, Neha Nanda","doi":"10.3390/idr17030056","DOIUrl":"10.3390/idr17030056","url":null,"abstract":"<p><p><b>Background:</b> Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, long COVID (LC) has become a significant global health burden. While knowledge about LC is accumulating, studies on its prevention are still lacking. <b>Methods:</b> We conducted a systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to investigate prevention options for LC. We identified fifteen articles on vaccines, seven on antivirals, and six on other interventions after searching for articles in the PubMed/MEDLINE database using the MeSH terms. <b>Results:</b> Most vaccine-related studies demonstrated a protective effect of COVID-19 vaccines against developing LC. Our review found an equivocal effect of antivirals, while metformin had a protective effect in outpatients and corticosteroids were protective in hospitalized patients against LC. Conversely, COVID-19 convalescent plasma and multiple micronutrient supplement did not confer any protection against LC. <b>Conclusions:</b> COVID-19 vaccination is vital as it not only prevents COVID-19 but also reduces the severity of illness and may help prevent LC. Further studies are warranted to shed light on preventive strategies for long COVID.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker of Fournier's Gangrene Severity: A Meta-Analysis.","authors":"Konstantinos Seretis, Nikolaos Bounas, Konstantinos Sfaelos, Georgios Gaitanis, Ioannis Bassukas","doi":"10.3390/idr17030055","DOIUrl":"10.3390/idr17030055","url":null,"abstract":"<p><strong>Background/objectives: </strong>Fournier's Gangrene (FG) is a severe and potentially fatal necrotizing infection of the perianal and genital regions, which necessitates prompt therapeutic interventions to prevent disease progression. Accruing evidence from recent research indicates that the neutrophil‒to-lymphocyte ratio (NLR) can predict clinical severity and mortality risk in patients with critical illnesses across various etiologies. This meta-analysis aimed to assess the efficacy of NLR as a prognostic indicator for mortality in patients with FG.</p><p><strong>Methods: </strong>An electronic literature search was conducted across several databases from their inception to 31 May 2024, following a predetermined protocol. Study quality was evaluated using the Cochrane risk of bias tool. A random-effect model was utilized to synthesize the available data.</p><p><strong>Results: </strong>Twelve studies reporting on 767 patients were included in the meta-analysis. Higher NLR levels at presentation were recorded in non-survivors than in survivors (MD = 4.49 [95% CI: 0.67-8.32]; <i>p</i> = 0.02). A 76% increased mortality risk was detected for patients with an NLR ≥ 8 (1.76 RR [1.35-2.3], <i>p</i> = 0.0001), and the mortality risk was more than twofold greater for patients with an NLR ≥ 10 compared to the remaining patients (RR = 2.31 [1.27-4.21], <i>p</i> = 0.006). All included studies exhibited a moderate to serious risk of bias.</p><p><strong>Conclusions: </strong>This meta-analysis reveals that the NLR represents a promising biomarker that can serve as a prognostic indicator in patients with FG. Future studies should address the establishment of proper disease-specific cutoff values to aid in clinical decision-making.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The PJI-TNM Classification as Predictor for Revision-Free Implant Survival Rates in Patients with Periprosthetic Joint Infection of the Hip or Knee Joint.","authors":"Frank Sebastian Fröschen, Lisa Greber, Ernst Molitor, Gunnar Thorben Rembert Hischebeth, Alexander Franz, Thomas Martin Randau","doi":"10.3390/idr17030054","DOIUrl":"10.3390/idr17030054","url":null,"abstract":"<p><strong>Background: </strong>Periprosthetic joint infections (PJIs) remain a major challenge in arthroplasty. This study tries to evaluate the PJI-TNM classification as predictor for the revision-free implant survival in patients with PJI of the hip or knee joint.</p><p><strong>Methods: </strong>To this end, we perform a retrospective study of all consecutive patients with PJI of an inlying hip or knee arthroplasty between January 2015 and December 2019.</p><p><strong>Results: </strong>A total of 443 cases (hip: <i>n</i> = 247; knee <i>n</i> = 196) were identified. In total, 439 patients underwent surgery (DAIR: <i>n</i> = 138 cases (31%), explantation: <i>n</i> = 272 (61%), irrigation with debridement without exchange of implant components: <i>n</i> = 29 (6.5%)). Four patients refused surgical treatment and 39.5% were lost to follow-up. In total, 78 patients died during follow-up and 27 deaths were directly related to PJI/complications during treatment. Patients with inlying \"standard\"-implants (<i>p</i> < 0.001) and without previous history of PJI (<i>p</i> = 0.002) displayed a significantly higher postoperative revision-free implant survival. In terms of the PJI-TNM subclassification, patients with loosened implants but without soft-tissue defects (T1) displayed the highest revision-free implant survival. In contrast, patients classified as M3 (no surgical treatment possible) displayed an inferior outcome compared to M0, M1, or M2. Patients with different N-subclassifications (\"non-human cells\"/causative pathogen) did not display differences in revision-free implant survival.</p><p><strong>Conclusions: </strong>The PJI-TNM classification is well suited to classify PJIs. Its complexity allows for more than 500 different combinations of classifications. Further validation data are needed, but to us, the PJI-TNM classification seems to offer the possibility of comparing patients with PJIs. It may, therefore, be a very valuable tool in order to compare cohorts with PJIs and provide individual data for patient specific outcomes.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Pulmonary Fibrosis and COVID-19-Related Pneumonia in a Pembrolizumab-Treated Patient.","authors":"Alberto Zolezzi, Gina Gualano, Annelisa Mastrobattista, Pietro Vittozzi, Virginia Di Bari, Carlotta Cerva, Silvia Mosti, Antonio Lugini, Fabrizio Albarello, Federica Di Stefano, Maria Beatrice Valli, Fabrizio Palmieri","doi":"10.3390/idr17030053","DOIUrl":"10.3390/idr17030053","url":null,"abstract":"<p><p>Pembrolizumab is used as a first-line treatment of non-small cell lung cancer. Pneumonitis and interstitial lung disease are among the most common immune-related adverse events. The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on patients with cancer treated with chemotherapy or immune checkpoint inhibitors (ICIs) is not fully known. Blocking immune checkpoints may conversely augment dysfunctional T-cell responses in severe patients and, in turn, mediate immunopathology. Here, we present a case of SARS-CoV-2 infection complicated by acute respiratory distress syndrome (ARDS) and a fibrotic-like pattern in a patient treated with pembrolizumab for lung cancer. The patient showed a dramatic clinical and radiological response after steroid therapy. Further research is needed to better understand the long-term implications of pembrolizumab therapy in patients recovering from coronavirus disease 2019 (COVID-19) and to develop evidence-based guidelines for managing these complex cases. Patients undergoing oncologic immunotherapy might benefit from early high-dose steroid treatment in cases of viral infections, such as SARS-CoV-2.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delineating the Significance of Several Inflammatory Markers in a Lung Tuberculosis Cohort During the Active and Post-Tuberculosis Stages of the Disease: An Observational Study in Cape Town, South Africa (2019 to 2024).","authors":"Chrisstoffel Jumaar, Lindiwe Malefane, Steve Jacobs, Olakunle Sanni, Elize Louw, Nicola Baines, Carmen Payne, Sigrid Schulz, Carl Lombard, Merga Feyasa, David Maree, Shantal Windvogel, Hans Strijdom, Benjamin Botha, Brian Allwood, Gerald J Maarman","doi":"10.3390/idr17030052","DOIUrl":"10.3390/idr17030052","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary tuberculosis (TB) frequently leads to long-term lung complications that contribute to increased mortality. Understanding the pathogenesis of post-TB lung impairments is crucial for improving long-term outcomes in TB patients; yet this area remains poorly researched.</p><p><strong>Methods: </strong>Our study assessed circulatory inflammatory markers in patients who completed TB treatment more than one year before enrolment (population 1) and patients receiving in-hospital treatment for active drug-sensitive TB (population 2).</p><p><strong>Results: </strong>IL-6 was seven times higher in both populations compared to the normal range. IL-8 was below the limit of detection (LOD) in population 1, while it was approximately 2.5 times higher in population 2 compared to the normal range. TNF-α was 21 times higher in population 1 and 19 times higher in population 2 compared to the normal range. CRP was almost 49 times higher in both populations, and IL-1Ra was below the LOD in population 1, while it was ~1.5 times higher in population 2 compared to the normal range.</p><p><strong>Conclusions: </strong>These inflammatory biomarkers correlated well with lung function in the post-TB state, and their high levels suggest a persistent pro-inflammatory state post-TB, which may contribute to post-TB lung disease. More research is warranted to better understand this phenomenon, but these findings may highlight a need to consider anti-inflammatory therapy for patients with post-TB lung disease, especially since these high levels of cytokines can directly contribute to lung damage.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stage-Specific Immune Responses to AgB T-Peptides in Patients with Cystic Echinococcosis.","authors":"Settimia Sbarra, Ambra Vola, Francesca Tamarozzi, Saeid Najafi-Fard, Alessandra Ludovisi, Antonella Teggi, Emanuele Nicastri, Fabrizio Albarello, Enrico Brunetti, Delia Goletti, Linda Petrone","doi":"10.3390/idr17030051","DOIUrl":"10.3390/idr17030051","url":null,"abstract":"<p><p><b>Background:</b> The identification of parasite- and stage-specific antigens is crucial for the development of new diagnostic tests for cystic echinococcosis (CE). We previously analysed the interleukin (IL)-4 response to T-specific peptides corresponding to the immunogenic regions of the five antigen B (AgB) subunits, demonstrating that AgB1 is the most immunogenic protein and that the response to all AgB peptides is associated with viable cysts. However, the response in patients with CE3a (WHO-IWGE) cystic stage was not evaluated and no other immunological factors besides IL-4 were included in the analysis. <b>Methods:</b> Four study groups were defined: \"CE3a group\" (transitional cysts), \"CE3b group\" (active cysts), \"CE4/CE5 group\" (inactive cysts), and \"NO CE-group\" encompassing patients with non-CE cysts (controls). Whole blood was stimulated in vitro with the five different T-specific peptide pools corresponding to the five AgB subunits and with a pool containing all five peptides' pools (total pool). IL-4 and other immunological markers were evaluated by ELISA and a multiplex assay, respectively. <b>Results:</b> Twenty-four patients with CE (CE3a-group n = 3; CE3b-group n = 6; CE4/CE5-group n = 15) and 14 subjects with non-CE cysts were enrolled. IL-4 levels in response to AgB1 and AgB3 pools were significantly increased in CE compared to NO CE groups (<i>p</i> = 0.0201, <i>p</i> = 0.0041). Within the CE patients, the highest IL-4 median level was observed in response to the AgB total pool, the AgB3 and AgB4 pools, followed by the AgB1 pool. Moreover, the IL-4 levels in response to the AgB1 pool were found to be significantly higher in the CE3b group compared to the CE4/CE5 group (<i>p</i> = 0.0070), while no differences were found for the CE3a group. As for other cytokines, we found higher IL-7 levels in response to the AgB4 pool in the CE4/CE5 group compared to the CE3b group (<i>p</i> = 0.0012), higher IL-2 levels in response to the AgB1 pool and AgB total pool in CE3b patients compared to controls (<i>p</i> = 0.0016), and higher IL-13 levels in response to the AgB total pool in patients with CE3b and CE4/CE5 cysts compared to NO CE (<i>p</i> = 0.0016; <i>p</i> = 0.0009). <b>Conclusions:</b> These results contribute to a better knowledge of the immune interplay in the presence of CE and may be useful for further exploring the use of recombinant proteins/peptides in cytokine release assays for the diagnosis and follow-up of CE.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Antibiotic Potential of a Serine Protease from <i>Solanum trilobatum</i> Against <i>Staphylococcus aureus</i> Biofilms.","authors":"Manohar Radhakrishnan, Kanal Elamparithi Balu, Lakshminarayanan Karthik, Raghavendra Sashi Krishna Nagampalli, Eswar Kumar Nadendla, Gunasekaran Krishnasamy","doi":"10.3390/idr17030050","DOIUrl":"10.3390/idr17030050","url":null,"abstract":"<p><strong>Background: </strong>Multi-antibiotic resistance has become an alarming issue in treating bacterial infections in both community and medical environments. Globally, the scientific community has been exploring multi-antibiotic techniques to find new ways to address this challenge. To address this critical challenge and explore alternative antibiotic treatments, we investigated the potential of <i>Solanum trilobatum</i>, an edible and medicinally important herb plant in Ayurvedic medicine.</p><p><strong>Methods: </strong>Our research focused on a 60 kDa serine protease isolated and purified from the leaves of <i>S. trilobatum</i>, which showed evidence of possessing hydrolase activity. In this study, we examined the capability of the purified enzyme to eradicate preformed biofilms of <i>S. aureus</i> in combination with ampicillin. Additionally, we assessed the stability of the enzyme in the presence of metal ions and detergents.</p><p><strong>Results: </strong>Enzyme kinetics revealed a Vmax of 48.63 µM/min and a Km of 14.08 µM, indicating efficient enzymatic activity. Furthermore, the enzyme exhibited maximum activity at physiological pH, suggesting its potential effectiveness under physiological conditions.</p><p><strong>Conclusions: </strong>Our preliminary findings highlight the promising role of this enzyme as a potential agent to combat S. aureus biofilms, especially when used in conjunction with ampicillin, as an alternative antibiotic approach.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiological Surveillance and Antimicrobial Susceptibility Observations on Peritoneal Dialysis-Associated Peritonitis in an Outpatient German Reference Center.","authors":"Annemarie Albert, Stefan Richter, Lisa C Costello-Boerrigter, Philipp Stieger, Rainer Peter Woitas, Rüdiger C Braun-Dullaeus, Christian Albert","doi":"10.3390/idr17030049","DOIUrl":"10.3390/idr17030049","url":null,"abstract":"<p><p><b>Background</b>: Peritonitis is a relevant complication in peritoneal dialysis (PD). The initial empirical antibiotic therapy depends on the center-specific distribution of microorganisms and the microbial susceptibility profiles. However, data on the locoregional germ spectrum in Germany are insufficient regarding the current recommended empirical antibiotic regimens of either cefepime as monotherapy or the combination of cefazolin and ceftazidime. <b>Methods</b>: This retrospective single-center study of routine clinical patient data analyzes the range of infecting organisms causing PD-associated peritonitis and their corresponding antimicrobial resistances during the 2015 to 2022 timeframe. We used Ordinary Least-Squares regression to model trends in the detection of microbiological spectrum samples. The 'reporting of studies conducted using observational routinely collected health data' (RECORD) statement was acknowledged. <b>Results</b>: There were 80 documented peritonitis episodes with 99 causal etiologies sampled. Of those, eighty-seven were bacterial, three were fungi (3%), eight had no microbial growth (8%), and one more had missing data. The largest group of microorganisms detected were Gram-positive bacteria (N = 56, 56.6%), predominantly sampled as Staphylococcacea, Enterococcaceae, and Streptococcaceae (<i>Staphylococcus aureus</i>, 14.1%). Gram-negative bacteria were found in 31.3% of samples (N = 31), predominantly Enterobacteriaceae (<i>Escherichia coli</i>, 9%). In total, 34 different microorganisms were identified. On one occasion, methicillin-resistant <i>Staphylococcus epidermidis</i> and one sample of multi-resistant <i>Serratia marcescens</i> were identified. Methicillin-resistant <i>Staphylococcus aureus</i> and vancomycin-resistant enterococci were not detected. Fungi were found in three peritonitis episodes. Regression analyses did not indicate changes in the general microbiological spectrum during the observational timeframe. The center-specific peritonitis rates were below the recommended rates of the International Society for Peritoneal Dialysis for all years studied. <b>Conclusions</b>: The recommended empiric therapy was suitable at our center, with a few exceptions for non-specific pathogens and for those with β-lactamases or enterococci. When there is no clinical response to empiric therapy, alternative antibiotics should be considered accordingly. The retrospective data are limited to the reported outcome measures.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}