{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T19:02:57Z","timestamp":1783191777805,"version":"3.54.6"},"reference-count":5,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Nephrol Dial"],"abstract":"<jats:p>Introduction: Peritoneal dialysis (PD)-associated peritonitis caused by rare non-fermenting Gram-negative organisms represents a diagnostic and therapeutic challenge, particularly in patients with prolonged antibiotic exposure and biofilm-associated catheter infections. Case Presentation: We report the case of a 44-year-old male PD patient who developed relapsing polymicrobial PD-associated peritonitis involving Elizabethkingia miricola, Brevundimonas diminuta, Stenotrophomonas maltophilia, and Staphylococcus haemolyticus. Despite repeated susceptibility-guided intraperitoneal antibiotic therapy, inflammatory markers and dialyzate leukocytosis persisted. Multiple cultures consistently identified rare non-fermenting Gram-negative pathogens. Following prolonged discussion, the PD catheter was removed, and the patient transitioned to hemodialysis, followed by targeted oral antimicrobial therapy. Clinical and laboratory resolution occurred within 3 weeks after catheter removal. Conclusion: Rare environmental non-fermenting Gram-negative pathogens should be recognized as clinically relevant causes of relapsing PD-associated peritonitis. Persistent or polymicrobial infections should prompt early consideration of catheter removal in accordance with current ISPD recommendations.<\/jats:p>","DOI":"10.1159\/000551489","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T17:01:02Z","timestamp":1773334862000},"page":"63-68","source":"Crossref","is-referenced-by-count":1,"title":["Relapsing Polymicrobial Peritoneal Dialysis-Associated Peritonitis Caused by Rare Non-Fermenting Gram-Negative Pathogens: A Case Report"],"prefix":"10.1159","volume":"16","author":[{"given":"Ben","family":"Hammoud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Schiefer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9055-6728","authenticated-orcid":false,"given":"Peter R.","family":"Mertens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2011.00057"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1126\/science.284.5418.1318"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3201\/eid0702.010226"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1177\/08968608221080586"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2017.1419116"}],"container-title":["Case Reports in Nephrology and Dialysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000551489","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T16:01:24Z","timestamp":1779379284000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000551489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,12]]},"references-count":5,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000551489","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.31670980","asserted-by":"subject"}]},"ISSN":["2296-9705"],"issn-type":[{"value":"2296-9705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,12]]}}}