Fungal microbiota in peritoneal dialysis effluent related peritonitis patients by amplicon sequencing of internal transcribed spacer based on Oxford nanopore Technologies

Fungal peritonitis (FP) is a rare and severe complication resulting from fungal infections of the peritoneum. It has recently garnered increased attention due to rising both incidence and potential mortality. Early recognition and rapid intervention are essential for improving patient outcomes, as untreated FP can progress to sepsis and multi-organ failure if not treated appropriately. Culture-negative fungal peritonitis is commonly observed, and its presence should be further considered. This study aimed to utilize Oxford Nanopore Technologies (ONT) sequencing to investigate the fungal profiles present in peritoneal dialysis effluent (PDE) from patients experiencing PD-related peritonitis, based on internal transcribed spacer (ITS). The results indicated that the ONT was able to identify fungal taxa in 69 out of 104 samples (66.3 %), which included mixed organisms. The predominant phyla identified in the PDE sample were Basidiomycota, followed by Ascomycota and Glomeromycota. Notably, Wallemia was the most frequently detected fungal genus suggesting the fungal thrive in moist environments and can contaminate dialysis system. This observation suggests a possible association with opportunistic infections in immunocompromised individuals, particularly those undergoing peritoneal dialysis. In conclusion, ONT offers a promising approach for fungal taxonomic classification, even though the DNA extracted from the samples was of low abundance.