{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T06:04:46Z","timestamp":1784009086756,"version":"3.55.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Peritoneal dialysis-associated peritonitis (PDAP) is a serious complication of peritoneal dialysis (PD), contributing significantly to hospitalization rates and mortality. In recent years, infections caused by uncommon pathogens such as\n                      <jats:italic>Coxiella burnetii<\/jats:italic>\n                      have increasingly been identified, posing significant challenges to managing PDAP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      We report a 62-year-old male hospitalized for recurrent PDAP unresponsive to empirical antibiotics (meropenem, later meropenem\/vancomycin). Metagenomic next-generation sequencing (mNGS) of peritoneal fluid identified\n                      <jats:italic>C. burnetii<\/jats:italic>\n                      . Intravenous omadacycline was initiated as part of a multi-agent regimen (100 mg daily after 200 mg loading dose). Within 48 h, hemodynamic stability was achieved, and inflammatory markers (procalcitonin, C-reactive protein, effluent white blood cell count) normalized progressively over the subsequent week. The patient recovered fully and was discharged, and remained relapse-free during 3 months of follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This case highlights the critical importance of identifying pathogens in patients with PDAP. Despite significant confounders (concurrent broad-spectrum antibiotics, ICU support, and polymicrobial infection) that limit definitive attribution, the use of omadacycline was associated with clinical recovery and suggests a potential role as an alternative therapeutic option for\n                      <jats:italic>Coxiella burnetii<\/jats:italic>\n                      infection. Further studies are warranted to validate its efficacy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1829483","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:37:24Z","timestamp":1784007444000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Omadacycline for peritoneal dialysis-associated peritonitis caused by Coxiella burnetii: a case report and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaobing","family":"Hong","sequence":"first","affiliation":[{"name":"Department of Pharmacy, The Second Affiliated Hospital, Shantou University Medical College","place":["Shantou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zinan","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Second Affiliated Hospital, Shantou University Medical College","place":["Shantou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zelin","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Affiliated Hospital, Shantou University Medical College","place":["Shantou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbo","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Affiliated Hospital, Shantou University Medical College","place":["Shantou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianpeng","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Second Affiliated Hospital, Shantou University Medical College","place":["Shantou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijian","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Second Affiliated Hospital, Shantou University Medical College","place":["Shantou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuming","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Second Affiliated Hospital, Shantou University Medical College","place":["Shantou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zejian","family":"Kuang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Second Affiliated Hospital, Shantou University Medical College","place":["Shantou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1038\/nrneph.2016.181","article-title":"Changes in the worldwide epidemiology of peritoneal dialysis.","volume":"13","author":"Li","year":"2017","journal-title":"Nat Rev 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