Background and Objectives: Septic arthritis is a medical emergency associated with high morbidity and mortality. The incidence rate of septic arthritis among dialysis patients is higher than the general population, and dialysis patients with bacteremia frequently experience adverse outcomes. The aim of this study was to identify the clinical features and risk factors for longer hospital length of stay (LOS), positive blood culture, and in-hospital mortality in dialysis patients with septic arthritis. Materials and Methods: The medical records of 52 septic arthritis dialysis patients admitted to our hospital from 1 January 2009 to 31 December 2020 were analyzed. The primary outcomes were bacteremia and in-hospital mortality. Variables were compared, and risk factors were evaluated using linear and logistic regression models. Results: Twelve (23.1%) patients had positive blood cultures. A tunneled cuffed catheter for dialysis access was used in eight (15.4%) patients, and its usage rate was significantly higher in patients with positive blood culture than in those with negative blood culture (41.7 vs. 7.5%, p = 0.011). Fever was present in 15 (28.8%) patients, and was significantly more frequent in patients with positive blood culture (58.3 vs. 20%, p = 0.025). The most frequently involved site was the hip (n = 21, 40.4%). The most common causative pathogen was Gram-positive cocci, with MRSA (n = 7, 58.3%) being dominant. The mean LOS was 29.9 ± 25.1 days. The tunneled cuffed catheter was a significant predictor of longer LOS (Coef = 0.49; Cl 0.25–0.74; p < 0.001). The predictors of positive blood culture were fever (OR = 4.91; Cl 1.10–21.83; p = 0.037) and tunneled cuffed catheter (OR = 7.60; Cl 1.31–44.02; p = 0.024). The predictor of mortality was tunneled cuffed catheter (OR = 14.33; Cl 1.12–183.18; p = 0.041). Conclusions: In the dialysis population, patients with tunneled cuffed catheter for dialysis access had a significantly longer hospital LOS. Tunneled cuffed catheter and fever were independent predictors of positive blood culture, and tunneled cuffed catheter was the predictor of in-hospital mortality. The recognition of the associated factors allows for risk stratification and determination of the optimal treatment plan in dialysis patients with septic arthritis.

Listeria monocytogenes causes listeriosis, a serious foodborne illness with a high mortality rate, especially in vulnerable populations. It accounts for 19% of foodborne deaths, with invasive cases having a mortality rate of up to 44%, leading to conditions like meningitis, bacteremia, and meningoencephalitis. However, the prognostic factors remain unclear. This study examines the hospital outcomes of invasive listeriosis and identifies risk factors for in-hospital and one-year mortality. We analyzed the electronic medical records of 118 hospitalized patients with non-perinatal, culture-proven invasive listeriosis collected over a 21-year period. The in-hospital mortality rate was 36.4%, with only 33.1% surviving one year and 22.0% surviving two years. The key findings indicate that a quick Sequential Organ Failure Assessment (qSOFA) score of ≥2 (OR 106.59, p < 0.001), respiratory failure (OR 7.58, p = 0.031), and shorter ampicillin duration (OR 0.53, p = 0.012) independently predicted poorer in-hospital outcomes. Additionally, a qSOFA score of ≥2 (OR 8.46, p < 0.001) and shorter ampicillin duration (OR 0.65, p < 0.001) were linked to higher one-year mortality. This study is the first to identify a qSOFA score of ≥2 as a significant marker for high-risk invasive listeriosis patients, with poorer outcomes linked to a qSOFA score of ≥2, respiratory failure, and shorter ampicillin use.

Background: Invasive aspergillosis (IA) carries high mortality, yet outcomes in patients with concomitant kidney disease are poorly characterized. We examined mortality and pragmatic clinical and mycological markers in hospitalized adults with both conditions. Methods: We retrospectively evaluated 88 adults hospitalized from 2002 to 2020 with proven or probable IA and kidney disease. Renal status was re-adjudicated into four mutually exclusive phenotypes; acute renal replacement therapy (RRT) was recorded separately. qSOFA was assessed at IA diagnosis. Bronchoalveolar lavage (BAL) fungal culture results were available for all 88 patients. In-hospital outcome was defined at discharge, and long-term follow-up was assessed from the index admission. Results: In-hospital mortality was 58.0% (51/88); 25 (28.4%) and 24 (27.3%) patients were documented alive at 1 and 2 years, respectively. Renal phenotypes were maintenance dialysis/end-stage kidney disease requiring long-term dialysis in 24 (27.3%), chronic kidney disease (CKD)CKD without acute kidney injury (AKI) in seven (8.0%), AKI without documented pre-existing CKD in 28 (31.8%), and AKI-on-CKD in 29 (33.0%); 26/64 non-maintenance-dialysis patients (40.6%) received acute RRT. qSOFA ≥ 2 occurred in 98.0% of nonsurvivors versus 40.5% of survivors (p < 0.001). BAL Aspergillus culture was positive in 30/88 (34.1%) and more frequent among nonsurvivors (45.1% vs. 18.9%; p = 0.013). A. fumigatus was the most frequently recorded BAL species (19/30, including mixed cultures). qSOFA ≥ 2 and BAL culture positivity were associated with in-hospital and 2-year mortality in exploratory adjusted analyses. Conclusions: Adults hospitalized with IA and kidney disease had poor outcomes. Acute physiologic severity and BAL Aspergillus culture provided complementary prognostic information, while renal re-phenotyping demonstrated marked host heterogeneity. Contemporary validation is needed.