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  • 1.

    【2hr】Effects of Antibiotics on the Intestinal Microbiota of Mice

    包量

    机译 抗生素对小鼠肠道菌群的影响
    摘要：Studies on human and mouse gastrointestinal microbiota have correlated the composition of the microbiota to a variety of diseases, as well as proved it vital to prevent colonization with resistant bacteria, a phenomenon known as colonization resistance. Antibiotics dramatically modify the gut community and there are examples of how antibiotic usage lead to colonization with resistant bacteria [e.g., dicloxacillin usage selecting for ESBL-producing carriage], as shown by Hertz et al. Here, we investigated the impact of five antibiotics [cefotaxime, cefuroxime, dicloxacillin, clindamycin, and ciprofloxacin] on the intestinal microbiota in mice. Five different antibiotics were each given to groups of five mice. The intestinal microbiotas were profiled by use of the IS-pro analysis; a 16S–23S rDNA interspace [IS]-region-based profiling method. For the mice receiving dicloxacillin and clindamycin, we observed dramatic shifts in dominating phyla from day 1 to day 5. Of note, diversity increased, but overall bacterial load decreased. For ciprofloxacin, cefotaxime, and cefuroxime there were few overall changes. We speculate that antibiotics with efficacy against the abundant anaerobes in the gut, particularly Bacteroidetes, can in fact be selected for resistant bacteria, disregarding the spectrum of activity.
  • 2.

    【2hr】Genomic Characterization of Escherichia coli Isolates Belonging to a New Hybrid aEPEC/ExPEC Pathotype O153:H10-A-ST10 eae-beta1 Occurred in Meat, Poultry, Wildlife and Human Diarrheagenic Samples

    包量

    机译 大肠杆菌分离物的基因组表征属于新的杂种aEPEC / ExPEC致病型O153：H10-A-ST10 eae-beta1，发生在肉，禽，野生动物和人类腹泻性样品中
    摘要：
  • 3.

    【2hr】Teacher and Student Views on the Feasibility of Peer to Peer Education as a Model to Educate 16–18 Year Olds on Prudent Antibiotic Use—A Qualitative Study

    包量

    机译 师生对同伴教育作为教育16-18岁青少年谨慎使用抗生素的模型的可行性的定性研究
    摘要：Peer education (PE) has been used successfully to improve young peoples’ health-related behaviour. This paper describes a qualitative evaluation of the feasibility of university healthcare students delivering PE, covering self-care and antibiotic use for infections, to biology students in three UK schools (16–18 years), who then educated their peers. Twenty peer educators (PEds) participated in focus groups and two teachers took part in interviews to discuss PE feasibility. Data were analysed inductively. All participants reported that teaching students about antibiotic resistance was important. PE was used by PEds to gain communication skills and experience for their CV. PEds confidence increased with practice and group delivery. Interactive activities and real-life illness scenarios facilitated enjoyment. Barriers to PE were competing school priorities, no antibiotic content in the non-biology curriculum, controlling disruptive behaviour, and evaluation consent and questionnaire completion. Participation increased PEds’ awareness of appropriate antibiotic use. This qualitative study supports the feasibility of delivering PE in schools. Maximising interactive and illness scenario content, greater training and support for PEds, and inclusion of infection self-care and antibiotics in the national curriculum for all 16–18-year olds could help facilitate greater antibiotic education in schools. Simplifying consent and data collection procedures would facilitate future evaluations.
  • 4.

    【2hr】In Vitro Antimicrobial Activity of Frankincense Oils from Boswellia sacra Grown in Different Locations of the Dhofar Region (Oman)

    包量

    机译 在Dhofar地区（阿曼）不同地区种植的乳香（Boswellia sacra）乳香油的体外抗菌活性
    摘要：Frankincense essential oils from have been commonly used to treat microbial infections from as early as the 11th century. The main feature of the plant is its gum resin, from which it is possible to obtain essential oils. In the present study, we focused on the comparative study of the oils extracted from the resins of three different cultivars (Najdi, Sahli and Houjri). From each of frankincense resin three successive essential oil samples (Grade 1, Grade 2, Grade 3) were obtained. Houjri gum resin gave the lowest percentage (5%) of total essential oil content but showed the maximum number of volatile components in all three grades. Najdi Grade 2 essential oil showed a minimum inhibitory concentration (MIC) of 52 mg/mL toward relevant pathogens and , and samples from Grade 2 of Sahily and Houjiri were particularly active against a dermatological strain , displaying MIC values of 0.264 and 0.66 mg/mL, respectively. Data obtained from in vitro studies showed that all essential oils had a significant antifungal effect against and , showing MIC values ranging from 54.56 to 0.246 mg/mL. This work aims to increase the number of substances available in the fight against pathogens and to combat the phenomenon of antibiotic resistance, encouraging the use of alternative resources, especially in non-clinical settings (farms, food processing, etc.).
  • 5.

    【2hr】Assessment of the Usefulness of Cefapirin and Cefalonium Disks for Susceptibility Testing of Staphylococcus aureus Isolates from Bovine Mastitis

    包量

    机译 评估头孢哌啶和头孢烯铵片在牛乳腺炎金黄色葡萄球菌分离物药敏试验中的有效性
    摘要：Cefapirin (CEP) and cefalonium (CNM) are first-generation cephalosporins widely used to treat bovine mastitis caused by Gram-positive bacteria including staphylococci. However, disks for susceptibility testing of those drugs in causative bacteria are not available. This study evaluated the efficacy of 10 µg and 30 µg pilot disks of CEP (CEP10 and CEP30) and CNM (CNM10 and CNM30) against 130 isolates from bovine mastitis. Scattergrams of minimum inhibitory concentrations (MICs) and zone diameters (ZDs) illustrated significant correlations between the MICs and ZDs of CEP10 ( = −0.912), CEP30 ( = −0.933), CNM10 ( = −0.847), and CNM30 ( = −0.807). The analysis by Normalized Resistance Interpretation indicated that the epidemiolocal cut-off value (ECV) of MIC for both cefapirin and cefalonium is ≤ 0.5 µg/mL, and the ECV of ZD for CEP10, CEP30, CNM10, and CNM30 were ≥ 22 mm, ≥ 25 mm, ≥ 22 mm, and ≥ 29 mm, respectively. We believe that both 10 μg and 30 μg CEP and CNM susceptibility disks will be helpful for guiding the appropriate use of these antibiotics for bovine mastitis. Further studies toward the establishment of clinical breakpoint of CEP and CNM would be needed for their routine use.
  • 6.

    【2hr】Pharmacokinetics of Macrolide Antibiotics and Transport into the Interstitial Fluid: Comparison among Erythromycin, Clarithromycin, and Azithromycin

    包量

    机译 大环内酯类抗生素的药代动力学和向组织液中的转运：红霉素，克拉霉素和阿奇霉素之间的比较
    摘要：Recent research has found higher levels and longer total exposure of azithromycin, a macrolide antibiotic agent, in the interstitial fluid of the skin than in the plasma. This unique distribution is expected to contribute to its antimicrobial activity at the primary infection site. However, it remains unclear whether this characteristic distribution in the extracellular tissue space is common to macrolide antibiotics or if it is azithromycin-specific, with most macrolides largely localized intracellularly. In this study, we investigated pharmacokinetic characteristics of erythromycin and clarithromycin in the interstitial fluid of the skin of rats after intravenous drug administration, and compared the results with our previously reported results on azithromycin. Interstitial fluid samples were directly collected from a pore on the skin using a dissolving microneedle array. We found that the total macrolide concentrations in the interstitial fluid were significantly different among three macrolides. The rank order of the interstitial fluid-plasma concentration ratio was azithromycin (3.8 to 4.9) > clarithromycin (1.2 to 1.5) > erythromycin (0.27 to 0.39), and this ratio was stable after dosing, whereas higher drug levels in the skin tissue than in the plasma were observed for all three macrolides. Our results suggest that lower erythromycin concentrations in the interstitial fluid than in the plasma contributes to the emergence of bacterial resistance in the extracellular tissue space. Monitoring of total macrolide concentrations in interstitial fluid may provide valuable information regarding antimicrobial effects and the emergence of bacterial resistance for the development of an appropriate pharmacokinetics–pharmacodynamics-based dosing strategy.
  • 7.

    【2hr】Investigating Bacteriophages Targeting the Opportunistic Pathogen Acinetobacter baumannii

    包量

    机译 靶向机会性病原鲍曼不动杆菌的噬菌体研究
    摘要：The multi-drug resistance of the opportunistic pathogen is of growing concern, with many clinical isolates proving to be resistant to last resort as well as front line antibiotic treatments. The use of bacteriophages is an attractive alternative to controlling and treating this emerging nosocomial pathogen. In this study, we have investigated bacteriophages collected from hospital wastewater in Thailand and we have explored their activity against clinical isolates of . Bacteriophage vB_AbaM_PhT2 showed 28% host range against 150 multidrug resistant (MDR) isolates and whole genome sequencing did not detect any known virulence factors or antibiotic resistance genes. Purified vB_AbaM_PhT2 samples had endotoxin levels below those recommended for preclinical trials and were not shown to be directly cytotoxic to human cell lines in vitro. The treatment of human brain and bladder cell lines grown in the presence of with this bacteriophage released significantly less lactate dehydrogenase compared to samples with no bacteriophage treatment, indicating that vB_AbaM_PhT2 can protect from induced cellular damage. Our results have also indicated that there is synergy between this bacteriophage and the end line antibiotic colistin. We therefore propose bacteriophage vB_AbaM_PhT2 as a good candidate for future research and for its potential development into a surface antimicrobial for use in hospitals.
  • 8.

    【2hr】Risk Factors of Initial Inappropriate Antibiotic Therapy and the Impacts on Outcomes of Neonates with Gram-Negative Bacteremia

    包量

    机译 最初不适当的抗生素治疗的危险因素及其对革兰氏阴性菌血症新生儿的影响
    摘要：Background: Timely appropriate empirical antibiotic plays an important role in critically ill patients with gram-negative bacteremia. However, the relevant data and significant impacts have not been well studied in the neonatal intensive care unit (NICU). Methods: An 8-year (1 January 2007–31 December 2014) cohort study of all NICU patients with gram-negative bacteremia (GNB) in a tertiary-care medical center was performed. Inadequate empirical antibiotic therapy was defined when a patient did not receive any antimicrobial agent to which the causative microorganisms were susceptible within 24 h of blood culture sampling. Neonates with GNB treated with inadequate antibiotics were compared with those who received initial adequate antibiotics. Results: Among 376 episodes of Gram-negative bacteremia, 75 (19.9%) received inadequate empirical antibiotic therapy. The cause of inadequate treatment was mostly due to the pathogen resistance to prescribed antibiotics (88.0%). Bacteremia caused by (Odds ratio [OR]: 20.8, < 0.001) and extended spectrum β-lactamase (ESBL)-producing bacteria (OR: 18.4, < 0.001) had the highest risk of inadequate treatment. Previous exposure with third generation cephalosporin was identified as the only independent risk factor (OR: 2.52, 95% CI: 1.18–5.37, = 0.018). Empirically inadequately treated bacteremias were significantly more likely to have worse outcomes than those with adequate therapy, including a higher risk of major organ damage (20.0% versus 6.6%, < 0.001) and infectious complications (25.3% versus 9.3%, < 0.001), and overall mortality (22.7% versus 11.0%, = 0.013). : Inadequate empirical antibiotic therapy occurs in one-fifth of Gram-negative bacteremias in the NICU, and is associated with worse outcomes. Additional prospective studies are needed to elucidate the optimal timing and aggressive antibiotic regimen for neonates who are at risk of antibiotic-resistant Gram-negative bacteremia.
  • 9.

    【2hr】Development of Antimicrobial Stewardship Programmes in Low and Middle-Income Countries: A Mixed-Methods Study in Nigerian Hospitals

    包量

    机译 在中低收入国家中制定抗菌药物管理计划：尼日利亚医院的混合方法研究
    摘要：Antimicrobial resistance (AMR) is a major concern facing global health today, with the greatest impact in developing countries where the burden of infectious diseases is much higher. The inappropriate prescribing and use of antibiotics are contributory factors to increasing antibiotic resistance. Antimicrobial stewardship programmes (AMS) are implemented to optimise use and promote behavioural change in the use of antimicrobials. AMS programmes have been widely employed and proven to improve antibiotic use in many high-income settings. However, strategies to contain antimicrobial resistance have yet to be successfully implemented in low-resource settings. A recent toolkit for AMS in low- and middle-income countries by the World Health Organisation (WHO) recognizes the importance of local context in the development of AMS programmes. This study employed a bottom-up approach to identify important local determinants of antimicrobial prescribing practices in a low-middle income setting, to inform the development of a local AMS programme. Analysis of prescribing practices and interviews with prescribers highlighted priorities for AMS, which include increasing awareness of antibiotic resistance, development and maintenance of guidelines for antibiotic use, monitoring and surveillance of antibiotic use, ensuring the quality of low-cost generic medicines, and improved laboratory services. The application of an established theoretical model for behaviour change guided the development of specific proposals for AMS. Finally, in a consultation with stakeholders, the feasibility of the plan was explored along with strategies for its implementation. This project provides an example of the design, and proposal for implementation of an AMS plan to improve antibiotic use in hospitals in low-middle income settings.
  • 10.

    【2hr】Biological Activities of Essential Oils from Leaves of Paramignya trimera (Oliv.) Guillaum and Limnocitrus littoralis (Miq.) Swingle

    包量

    机译 三叶草（Guillaum and Limnocitrus littoralis（Miq。）Swingle）的三叶草精油的生物活性
    摘要：The present study aimed to determine the bioactivities of essential oils extracted from the leaves of and , including cytotoxicity, antiviral, antibacterial, antimycotic, and antitrichomonas effects. Herein, it was indicated that and oils showed no cytotoxicity on normal cells, namely MT-4, BHK-21, MDBK, and Vero-76. oil (i) exhibited the strongest inhibition against with MIC and MLC values of 2% ( ); (ii) showed MIC and MLC values of 8% ( ) in ; and (iii) in the remaining strains, showed MIC and MLC values greater than or equal to 16% ( ). On the other hand, oil (i) displayed the strongest inhibition against and with 2% ( ) of MIC and MLC; and (ii) in the remaining strains, possessed MIC and MLC greater than or equal to 16% ( ). In addition, antitrichomonas activities of the oils were undertaken, showing IC , IC , MLC values, respectively, at 0.016%, 0.03%, and 0.06% ( ) from and 0.03%, 0.06%, 0.12% ( ) from , after 48 h of incubation. The oils were completely ineffective against ssRNA+ (HIV-1, YFV, BVDV, Sb-1, CV-B4), ssRNA- (RSV, VSV), dsRNA (Reo-1), and dsDNA (HSV-1, VV) viruses. This is the first report describing the cytotoxicity, antiviral, antibacterial, antimycotic, and antitrichomonas activities of the essential oils of and .
  • 11.

    【2hr】Prevalence of Virulence Genes and Antimicrobial Resistances in E. coli Associated with Neonatal Diarrhea, Postweaning Diarrhea, and Edema Disease in Pigs from Austria

    包量

    机译 奥地利猪中与新生儿腹泻，断奶后腹泻和水肿病相关的大肠杆菌中毒力基因的流行和抗菌素耐药性
    摘要：Increasing numbers of multi-resistant from clinical specimens emphasize the importance of monitoring of their resistance profiles for proper treatment. Furthermore, knowledge on the presence of virulence associated genes in isolates from European swine stocks is scarce. Consequently, a total of 694 isolated between 2016 and 2018 from diarrheic piglets of Austrian swine herds were investigated. The isolates were tested for their susceptibility to twelve antibiotics using agar disk diffusion test and for the presence of 22 virulence associated genes via PCR. Overall, 71.9, 67.7, and 49.5% of all isolates were resistant to ampicillin, tetracycline, and trimethoprim-sulfamethoxazole, while resistance levels to gentamicin and fosfomycin were 7.7 and 2.0%, respectively. Resistance frequency to ciprofloxacin was higher than in previous studies. Isolates were more likely to be resistant to ampicillin if they were also resistant to ciprofloxacin. No isolate was resistant to meropenem or amikacin. Virulence genes were detected more frequently in isolates expressing hemolytic activity on blood agar plates. The detection rate of was increased in negative isolates. We assume, that hemolytic activity and absence of could be considered as potential indicators for the virulence of in piglets.
  • 12.

    【2hr】Photodynamic Therapy in the Inactivation of Microorganisms

    包量

    机译 灭活微生物中的光动力疗法。
    摘要：The growing emergence of microbial resistance to conventional antimicrobials, due their dissemination in the environment, and excessive or inadequate prescriptions, associated with the globalization of pathogenic microorganisms’ transmission, make the discovery of new effective therapies to combat infection of extreme urgency. It was estimated that, if nothing will be done in the meantime, the cost of microbial resistance in terms of global production lost between 2015 and 2050 would be 100 trillion USD, and by 2050 microbial resistance will kill 10 million people per year, outweighing the death caused by cancer [ ].
  • 13.

    【2hr】Antibacterial Peptides

    包量

    机译 抗菌肽
    摘要：As natural host defense compounds produced by numerous prokaryotic and eukaryotic life forms, antimicrobial peptides (AMPs) are now emerging as solid candidate chemotherapeutic drugs to fight against the various types of pathogenic Gram-positive and Gram-negative bacteria, especially those resistant to current antibiotics. This special issue of has been focused on the various aspects of such AMPs, from their discovery to the structural and functional characterization thereof. The authors of articles published in this special issue (10 articles, including a review article) are thanked for their important contributions to this essential field of applied research, by allowing a more ‘in-depth’ knowledge on the AMPs.
  • 14.

    【2hr】Innate Antimicrobial Defense of Skin and Oral Mucosa

    包量

    机译 皮肤和口腔粘膜的先天抗菌防御
    摘要：This special issue intends to review and update our understanding of the antimicrobial defense mechanisms of the skin and oral cavity. These two environments are quite different in terms of water, pH, and nutrient availability, but have some common antimicrobial factors. The skin surface supports the growth of a limited range of microorganisms but provides a hostile environment for others. The growth of most microorganisms is prevented or limited by the low pH, scarcity of some nutrients such as phosphorus and the presence of antimicrobial peptides, including defensins and cathelicidins, and antimicrobial lipids, including certain fatty acids and long-chain bases. On the other hand, the oral cavity is a warm, moist, nutrient rich environment which supports the growth of diverse microflora. Saliva coating the oral soft and hard surfaces determines which microorganisms can adhere to these surfaces. Some salivary proteins bind to bacteria and prevent their attachment to surfaces. Other salivary peptides, including defensins, cathelicidins, and histatins are antimicrobial. Antimicrobial salivary proteins include lysozyme, lactoferrin, and lactoperoxidase. There are also antimicrobial fatty acids derived from salivary triglycerides and long-chain bases derived from oral epithelial sphingolipids. The various antimicrobial factors determine the microbiomes of the skin surface and the oral cavity. Alterations of these factors can result in colonization by opportunistic pathogens, and this may lead to infection. Neutrophils and lymphocytes in the connective tissue of skin and mucosa also contribute to innate immunity.
  • 15.

    【2hr】Nontraditional Antibiotics—Challenges and Triumphs

    包量

    机译 非传统抗生素—挑战和胜利
    摘要：The pursuit of nontraditional antibiotics is becoming an increasingly important means to tackle seemingly insurmountable challenges faced by contemporary antibiotic researchers as they overcome the shifting landscape of bacterial pathogenesis, particularly for Gram-negative bacteria. Defined as therapeutic modalities that do not fit within the traditional direct-acting small molecule paradigm, the scientific merit, translational potential and likely pitfalls of nontraditional approaches was recently reviewed [ ]. Encouragingly, there is an unprecedented level of activity around nontraditional therapies based on a recent analysis of the global preclinical antibacterial pipeline [ ]. Although the future potential of nontraditional therapies is viewed with cautious optimism, adequate resourcing will be critical to demonstrate clinical impact, especially when many of the translational criteria associated with direct-acting small molecule therapeutics will likely be incongruent with the nontraditional development pathway. This is reinforced by the sobering point that nontraditional therapies will likely be used as adjunctive therapies alongside antibiotics, rather than replacing them, clouding clinical endpoints for regulatory approval [ ]. Thus, considerable work is still required to navigate the tortuous pathway to the regulatory approval and future acceptance of nontraditional therapies in clinical practice.
  • 16.

    【2hr】Antibiotics and Environment

    包量

    机译 抗生素与环境
    摘要：Since the discovery of penicillin by Alexander Fleming in 1928, the use of antibiotics has become the golden standard in the treatment of bacterial infections of all kinds. Nowadays antibiotics are not only used in healthcare and in veterinary medicine but they are also employed in many human activities worldwide, such as fish farming, aquaculture, agriculture and in raising livestock. Therefore, wastewater from agriculture, hospitals, farms or urban wastewater treatment plants is increasingly likely to contain ranges of antibiotics, which eventually reach environmental niches with no previous history of contact to these compounds, for instance through water seepage or soil fertilisation. Because of their complex chemical structures, many antibiotics are resistant to degradation and, particularly in polluted areas, they can persist in the environment where they are thought to exert a positive selection pressure toward antibiotic-resistant bacteria. Thus, the environment represents a potential reservoir of antibiotics as well as antibiotic-resistant pathogens, which can then enter the food chain, leading to the selection of an antibiotic-resistant microbiota.
  • 17.

    【2hr】Stewardship of Antibiotics for Multidrug-Resistant Gram-Negative Bacteria

    包量

    机译 耐多药革兰氏阴性菌抗生素的管理
    摘要：Nearly one year ago, we wrote the following introductory note for authors willing to submit their paper to our Special Issue entitled “Stewardship of Antibiotics for Multidrug-Resistant Gram-Negative Bacteria” in Antibiotics:
  • 18.

    【2hr】Diagnosis and Management of Cervicofacial Actinomycosis: Lessons from Two Distinct Clinical Cases

    包量

    机译 宫颈面部放线菌病的诊断和管理：来自两个不同临床病例的经验教训
    摘要：Members of the genus are non-spore-forming, anaerobic, and aerotolerant Gram-positive bacteria that are abundantly found in the oropharynx. They are the causative agents of actinomycosis, a slowly progressing (indolent) infection with non-specific symptoms in its initial phase, and a clinical course of extensive tissue destruction if left untreated. Actinomycoses are considered to be rare; however, reliable epidemiological data on their prevalence is lacking. Herein, we describe two representative and contrasting cases of cervicofacial actinomycosis, where the affected patients had distinctively different backgrounds and medical histories. Identification of the relevant isolates was carried out using matrix-assisted laser desorption/ionization mass spectrometry; antimicrobial susceptibility was performed using E-tests. Cervicofacial actinomycoses are the most frequent form of the disease; isolation and identification of these microorganisms from relevant clinical samples (with or without histological examination) is the gold standard for diagnosis. The therapy of these infections includes surgical debridement and antibiotic therapy, mainly with a penicillin-derivative or clindamycin.
  • 19.

    【2hr】Isolation of Tetracycline-Resistant Chlamydia suis from a Pig Herd Affected by Reproductive Disorders and Conjunctivitis

    包量

    机译 从繁殖障碍和结膜炎影响的猪群中分离抗四环素的猪衣原体
    摘要：Due to various challenges in diagnosing chlamydiosis in pigs, antibiotic treatment is usually performed before any molecular or antibiotic susceptibility testing. This could increase the occurrence of tetracycline-resistant isolates in the affected pig population and potentiate the reoccurrence of clinical signs. Here, we present a case of an Austrian pig farm, where tetracycline resistant and sensitive isolates were isolated from four finishers with conjunctivitis. On herd-level, 10% of the finishers suffered from severe conjunctivitis and sows showed a high percentage of irregular return to estrus. Subsequent treatment of whole-herd using oxytetracycline led to a significant reduction of clinical signs. Retrospective antibiotic susceptibility testing revealed tetracycline resistance and decreased susceptibility to doxycycline in half of the ocular isolates, and all isolates were able to partially recover following a single-dose tetracycline treatment in vitro. These findings were later confirmed in vivo, when all former clinical signs recurred three months later. This case report raises awareness of tetracycline resistance in and emphasizes the importance of preventative selection of tetracycline resistant isolates.
  • 20.

    【2hr】Management of a Case of Peritonitis Due to Neisseria gonorrhoeae Infection Following Pelvic Inflammatory Disease (PID)

    包量

    机译 盆腔炎（PID）后淋病奈瑟菌感染引起的腹膜炎的处理
    摘要：Pelvic inflammatory disease (PID), a serious infection in sexually active women, is one of the reasons for which females seek care in emergency departments and therefore represents an important public health problem. PID is the result of an endocervical infection with different microorganisms, which then ascend to the endometrium and fallopian tubes. Symptoms of PID may be mild and aspecific, making its diagnosis difficult. However, this clinical condition requires effective antibiotic treatment to reduce incidence of complications and late sequelae. We describe here a case of peritonitis as a complication of pelvic inflammatory disease (PID) due to infection in a 49-year-old woman who presented at the Emergency Department with acute abdominal pain.
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