Language：English   Publishing type：Research paper (scientific journal)  

BackgroundInfections can make it difficult to continue peritoneal dialysis (PD). Nontuberculous mycobacteria-associated PD (NTM-PD) infections, while rare, frequently pose a treatment challenge due to their intractable nature and the lack of established therapeutic guidelines. As a result, we aimed to investigate the clinical characteristics of NTM infections in patients undergoing PD.MethodsWe retrospectively examined consecutive patients with NTM-PD infections from 2012 to 2022. The cases were identified through microbiological records. The primary outcomes were all-cause mortality and transition to hemodialysis. Secondary outcomes included treatment duration and antimicrobial regimens. Outcomes were compared across different NTM species and between cases with and without infectious disease (ID) consultation.ResultsAmong 177 patients undergoing PD, we identified 22 NTM infections in 20 patients. The predominant species were M. chelonae (36%), M. fortuitum (36%), and M. abscessus (23%). Twelve patients were transitioned to hemodialysis, with no mortality. All M. abscessus infections (n = 5) required transition to hemodialysis, compared to 46% in other species. ID consultation (n = 15) was linked to more frequent antimicrobial susceptibility testing (60% vs. 0%, p < .05), longer treatment duration (5.7 vs. 1.2 months, p < .05), and increased use of combination therapies (100% vs. 43%, p < .05). However, ID consultation did not affect the frequency of transition to hemodialysis.ConclusionEarly identification of NTM species and timely ID consultation can help optimize management strategies for these challenging infections.

DOI： 10.1177/08968608251389780

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

Mycobacterium neoaurum is a rare cause of bacteremia, predominantly affecting immunocompromised hosts with indwelling catheters. A 75-year-old man receiving high-dose methotrexate therapy for primary central nervous system lymphoma without a central venous catheter (CVC) presented with fever. The acid-fast bacilli isolated from his blood cultures were identified as M. neoaurum through 16S rRNA sequencing. Despite broad-spectrum antimicrobial therapy, the patient developed persistent pancytopenia and toxic epidermal necrolysis, which ultimately led to multiple organ failure. M. neoaurum should be considered a potential pathogen in immunocompromised hosts, even in the absence of a CVC. Rapid identification and appropriate antimicrobial selection are essential when mycobacteria are isolated from blood culture.

DOI： 10.2169/internalmedicine.5633-25

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Language：Japanese   Publisher：(一社)日本感染症学会  

J-GLOBAL

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Language：English   Publishing type：Research paper (scientific journal)  

Erysipelothrix rhusiopathiae is a zoonotic, facultatively anaerobic, non-spore-forming, gram-positive bacillus. Although the serotypes and phylogenetic clades of E. rhusiopathiae strains isolated from animals have been shown to be closely related, the serotype identification of clinical isolates from human patients remains limited. We report a case of a 66-year-old woman with bacteremia caused by E. rhusiopathiae serotype 6. The patient had been admitted with aspiration pneumonia and heat stroke. She had no animal-related occupational history and had been receiving long-term oral prednisolone therapy for mixed connective tissue disease. Upon confirmation of E. rhusiopathiae positivity on blood cultures, she was treated with intravenous ampicillin for 10 days and achieved complete recovery. Agar gel precipitation and polymerase chain reaction tests identified the isolate as serotype 6. Surface protective antigen (Spa) typing by sequence analysis suggested a marine animal origin of infection. To the best of our knowledge, this is the first reported case of bacteremia caused by E. rhusiopathiae serotype 6 in humans. Spa typing through sequence analysis may provide variable information for identifying the infection source. E. rhusiopathiae carrying the SpaB gene should be considered in immunosuppressed patients, regardless of animal exposure history. Further studies are needed to elucidate the epidemiological distribution of serotypes among human clinical isolates.

DOI： 10.1016/j.idcr.2025.e02329

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: Organophosphate (OP) poisoning, a frequent method of suicide in the Asia-Pacific region and rural areas, inhibits cholinesterase (ChE), causing an acute cholinergic crisis. Pneumonia occurs in 20-50% of these cases, contributing to disease severity and mortality. However, data on the causative pathogens and the risk of drug-resistant bacteria in this patient population are limited. Thus, our study aimed to address these gaps. PATIENTS AND METHODS: This retrospective cohort study (April 2011-March 2023) investigated patients admitted to the intensive care unit (ICU) or emergency medical center at Niigata University Medical & Dental Hospital with acute OP poisoning. Data on patient demographics, pneumonia diagnosis, sputum culture results, prior antibiotic use, and risk factors for drug-resistant bacteria were collected. We also analyzed the detection rates of methicillin-resistant Staphylococcus aureus and SPICE (Serratia, Pseudomonas, indole-positive Proteus, Citrobacter, and Enterobacter) organisms. RESULTS: Among the 21 patients with OP poisoning, 13 (62%) developed pneumonia and received antibiotic treatment. They had a longer ICU stay, higher Sequential Organ Failure Assessment scores on admission, and lower serum ChE activity (<100 IU/L). Gram-negative bacilli (GNB) were observed in five sputum cultures from 12 patients with pneumonia, with Pseudomonas aeruginosa isolated from three cases. None of the patients had known risk factors for drug-resistant bacteria. CONCLUSION: Pneumonia in patients with OP poisoning was predominantly caused by GNB, particularly P. aeruginosa. Thus, despite the absence of known risk factors for drug-resistant bacteria, clinicians should consider the possibility of resistant pathogens when selecting empirical antibiotic therapy for pneumonia in these patients.

DOI： 10.2147/IDR.S556334

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Language：Japanese  

CiNii Books

J-GLOBAL

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Other Link： https://ndlsearch.ndl.go.jp/books/R000000004-I034353579

Language：Japanese   Publisher：(株)日本医事新報社  

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Language：Japanese   Publisher：(株)日本医事新報社  

J-GLOBAL

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Language：Japanese   Publisher：日本感染症学会・日本化学療法学会  

J-GLOBAL

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Language：Japanese   Publisher：(一社)日本感染症学会  

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