{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:50:37Z","timestamp":1791575437801,"version":"4.3.4"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"41","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hangzhou Science and Technology Plan Guidance Project","award":["2019123Y236"],"award-info":[{"award-number":["2019123Y236"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,9]]},"abstract":"\n Rationale:<\/jats:title>\n \n Ureaplasma urealyticum<\/jats:italic>\n is a rare cause of peritoneal dialysis-associated peritonitis (PDAP) that may be missed by routine culture. Here, we report a culture-negative case in which targeted next-generation sequencing (tNGS) supported rapid pathogen identification and treatment adjustment.\n <\/jats:p>\n <\/jats:sec>\n \n Patient concerns:<\/jats:title>\n A 41-year-old woman receiving continuous ambulatory peritoneal dialysis for\u2005>10 years presented with acute abdominal pain, cloudy dialysate, fever, and neutrophilic dialysate leukocytosis. The patient was diagnosed with PDAP.<\/jats:p>\n <\/jats:sec>\n \n Diagnoses:<\/jats:title>\n \n Repeated bacterial and fungal cultures and acid-fast staining were negative. tNGS of peritoneal dialysate detected\n U urealyticum<\/jats:italic>\n , which is considered the most likely causative pathogen.\n <\/jats:p>\n <\/jats:sec>\n \n Interventions:<\/jats:title>\n \n Empirical vancomycin plus ceftazidime, followed by vancomycin plus meropenem, was ineffective. The treatment was changed to oral doxycycline plus intraperitoneal levofloxacin after the tNGS results became available. A vaginal\n U urealyticum<\/jats:italic>\n isolate was subsequently resistant to levofloxacin; therefore, levofloxacin was replaced with intravenous azithromycin.\n <\/jats:p>\n <\/jats:sec>\n \n Outcomes:<\/jats:title>\n The abdominal pain resolved, the dialysate cleared, inflammatory markers decreased, the PD catheter was retained, and no recurrence occurred during the 1-month follow-up period.<\/jats:p>\n <\/jats:sec>\n \n Lessons:<\/jats:title>\n \n In persistent culture-negative PDAP that does not respond to cell wall-active antibiotics, clinicians should consider cell wall-deficient organisms such as\n Ureaplasma<\/jats:italic>\n . tNGS may complement conventional microbiological testing, but the results should be interpreted in the clinical context and, when possible, confirmed by an independent method.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/md.0000000000050996","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:00:27Z","timestamp":1791572427000},"page":"e50996","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Peritoneal dialysis-associated peritonitis caused by Ureaplasma urealyticum"],"prefix":"10.1097","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9543-0024","authenticated-orcid":false,"given":"Ting","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hangzhou First People\u2019s Hospital Tonglu Campus, Hangzhou, Zhejiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinjin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hangzhou First People\u2019s Hospital Tonglu Campus, Hangzhou, Zhejiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7322-0043","authenticated-orcid":false,"given":"Geping","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hangzhou First People\u2019s Hospital Tonglu Campus, Hangzhou, Zhejiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20261009","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1097\/01.OLQ.0000114653.26951.71","article-title":"Association of Ureaplasma urealyticum (biovar 2) with nongonococcal urethritis.","volume":"31","author":"Deguchi","year":"2004","journal-title":"Sex Transm Dis"},{"key":"R2-20261009","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1080\/1040841X.2020.1736986","article-title":"Ureaplasma species and preterm birth: current perspectives.","volume":"46","author":"Sprong","year":"2020","journal-title":"Crit Rev Microbiol"},{"key":"R3-20261009","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1159\/000534779","article-title":"Intrauterine detection of Ureaplasma species after vaginal colonization in pregnancy and neonatal outcome.","volume":"121","author":"Rittenschober-Boehm","year":"2024","journal-title":"Neonatology"},{"key":"R4-20261009","doi-asserted-by":"crossref","first-page":"S26","DOI":"10.1097\/INF.0000000000002859","article-title":"Perinatal infections with Ureaplasma.","volume":"40","author":"Stol","year":"2021","journal-title":"Pediatr Infect Dis J"},{"key":"R5-20261009","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1007\/s10096-025-05336-w","article-title":"Effects of Ureaplasma urealyticum infection in human genital tract on sperm DNA and semen quality in male patients.","volume":"45","author":"Zhao","year":"2026","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"R6-20261009","doi-asserted-by":"crossref","first-page":"860498","DOI":"10.3389\/fphar.2022.860498","article-title":"Prevalence and load of cervical Ureaplasma species with respect to intra-amniotic complications in women with preterm prelabor rupture of membranes before 34 weeks.","volume":"13","author":"Kacerovsky","year":"2022","journal-title":"Front Pharmacol"},{"key":"R7-20261009","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1177\/089686080202200322","article-title":"Ureaplasma urealyticum CAPD peritonitis following insertion of an intrauterine device: diagnosis by eubacterial polymerase chain reaction.","volume":"22","author":"Bailey","year":"2002","journal-title":"Perit Dial Int"},{"key":"R8-20261009","doi-asserted-by":"crossref","first-page":"242","DOI":"10.3747\/pdi.2009.00065","article-title":"Two cases of ascending peritonitis in CAPD.","volume":"30","author":"Rocca","year":"2010","journal-title":"Perit Dial Int"},{"key":"R9-20261009","doi-asserted-by":"crossref","first-page":"4310","DOI":"10.1128\/JCM.01045-10","article-title":"Ureaplasma urealyticum continuous ambulatory peritoneal dialysis-associated peritonitis diagnosed by 16S rRNA gene PCR.","volume":"48","author":"Yager","year":"2010","journal-title":"J Clin Microbiol"},{"key":"R10-20261009","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jare.2021.09.011","article-title":"Multilaboratory assessment of metagenomic next-generation sequencing for unbiased microbe detection.","volume":"38","author":"Han","year":"2022","journal-title":"J Adv Res"},{"key":"R11-20261009","doi-asserted-by":"crossref","first-page":"83","DOI":"10.2147\/IDR.S345991","article-title":"The diagnosis of severe fever with thrombocytopenia syndrome using metagenomic next-generation sequencing: case report and literature review.","volume":"15","author":"Zhan","year":"2022","journal-title":"Infect Drug Resist"},{"key":"R12-20261009","first-page":"4375","article-title":"Expert consensus on the application and practice of targeted next-generation sequencing in infectious diseases.","volume":"104","year":"2024","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"R13-20261009","article-title":"Application of targeted next-generation sequencing in the etiological diagnosis of peritoneal dialysis-associated peritonitis: a single-center prospective cohort study [published online ahead of print June 25, 2026].","author":"Ma","journal-title":"Int Urol Nephrol"},{"key":"R14-20261009","doi-asserted-by":"crossref","first-page":"e0175124","DOI":"10.1128\/spectrum.01751-24","article-title":"Laboratory validation of targeted next-generation sequencing assay for pathogen detection in lower respiratory infection.","volume":"13","author":"Yang","year":"2025","journal-title":"Microbiol Spectr"},{"key":"R15-20261009","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ijid.2023.03.032","article-title":"Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum: hidden pathogens in peritoneal dialysis-associated peritonitis.","volume":"131","author":"Wang","year":"2023","journal-title":"Int J Infect Dis"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000050996","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:00:29Z","timestamp":1791572429000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000050996"}},"subtitle":["A case report"],"short-title":[],"issued":{"date-parts":[[2026,10,9]]},"references-count":15,"journal-issue":{"issue":"41","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000050996","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,9]]},"assertion":[{"value":"2026-01-31","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}