Microbiology and outcomes of polymicrobial peritonitis associated with peritoneal dialysis: a register-based cohort study from the French Language Peritoneal Dialysis Registry

International audienceBACKGROUND: Previous studies have reported that polymicrobial peritonitis in peritoneal dialysis (PD) is associated with poor outcomes, but recent data from European cohorts are scarce. METHODS: We included from the French Language Peritoneal Dialysis Registry all patients ≥18 years of age who started PD between January 2014 and November 2020. We compared microbiology and patient characteristics associated with mono- and polymicrobial peritonitis. We assessed patient outcomes after a first polymicrobial peritonitis using survival analysis with competing events. We differentiated microorganisms isolated from dialysis effluent as enteric or non-enteric pathogens. RESULTS: A total of 8848 patients contributed 13 023 patient-years of follow-up and 3348 culture-positive peritonitis episodes, including 251 polymicrobial ones. This corresponded to rates of 0.32 and 0.02 episodes/patient-year, respectively. For most patients (72%) who experienced polymicrobial peritonitis, this was their first peritonitis episode. Enteric pathogens were more frequently isolated in polymicrobial than in monomicrobial peritonitis (57 versus 44%; P < .001). In both cases of peritonitis with and without enteric pathogens, the polymicrobial versus monomicrobial character of the peritonitis was not associated with mortality in patients who did not switch to haemodialysis {adjusted cause-specific hazard ratio [acsHR] 1.2 [95% confidence interval (CI) 0.3-5.0], P = .78 and 1.1 [95% CI 0.7-1.8], P = .73, respectively}. However, the risks of death and switch to haemodialysis were higher for monomicrobial peritonitis with enteric pathogens compared with those without [acsHR 1.3 (95% CI 1.1-1.7), P = .02 and 1.9 (95% CI 1.5-2.4), P < .0001, respectively]. CONCLUSION: Isolation of enteric pathogens, rather than the polymicrobial character of the peritonitis, is associated with poorer outcomes

Reconstruction of Curcuma aeruginosa secondary metabolite biosynthetic pathway using omics data

Curcuma aeruginosa or temu hitam is herbaceous plant with high therapeutic values in its rhizome that is widely used in traditional medicine. However, molecular studies on the secondary metabolite biosynthetic pathway of C. aeruginosa is still limited. Hence, the aim of this study was to explore and reconstruct the secondary metabolite biosynthetic pathway of C. aeruginosa rhizome by integrating the metabolite profiling and transcriptomic data. A total of 81 metabolites were identified in the rhizome of C. aeruginosa; amongst others are curzerene and β-Cubebene which are potent antioxidants. A total of 28,225 unigene were obtained from the transcriptomic sequencing of C. aeruginosa rhizome and analysed to identify potential genes associated with the biosynthesis of its metabolites. Of these, 43 unigenes were identified and mapped onto five sub-pathways; i.e. carotenoid biosynthetic pathway, diterpenoid biosynthetic pathway, monoterpenoid biosynthetic pathway, terpenoid and steroid biosynthetic pathway, and sesquiterpenoid and triterpenoid biosynthetic pathway. This study demonstrated a systematic bioinformatic approach to reconstruct a metabolic pathway in the rhizome of C. aeruginosa using bioinformatic approach