Clinical Focus ›› 2020, Vol. 35 ›› Issue (11): 1010-1014.doi: 10.3969/j.issn.1004-583X.2020.11.011
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Abstract: Objective To analyze the etiology, pathogen distribution and drug resistance of peritoneal dialysisassociated peritonitis (PDAP) in a single peritoneal dialysis center, and to provide reference for PDAP prevention and control.Methods The general data, bacterial culture, drug resistance analysis, curative effects and prognosis of 94 PDAP patients/times were retrospectively analyzed. Results Among 94 PDAP patients, The most common cause of infection was operational contamination (53.19%) which centered on grampositive bacterial infection, followed by intestinal infection(27.66%) which centered on gramnegative bacterial infection. Totally 65 cases of dialysate pathogen culture in 94 patients were positive, with a positive rate of 69.15%. A total of 67 bacterial strains were separated from 65 cases of dialysate pathogen culture, including 45 grampositive strains (67.16%) with Staphylococcus epidermidis as the most common, 20 gramnegative strains (29.85%) with Escherichia coli as most common, and 2 fungi(2.99%). Grampositive bacteria was highly resistant to penicillin (91.11%), erythromycin (91.11%) and oxacillin (88.89%), while it had no resistance to both linezolid and vancomycin. Gramnegative bacteria was not resistant to imipenem and meropenem, and its resistance to Ceftazidime (10.00%) and cefepime (5.00%) was relatively low. In addition, none of the fungi showed resistance to fluconazole, amphotericin B, 5fluorouracil and itraconazole. Totally 51 cases(78.46%) of the 65 cases were cured after the treatment, and 14 cases (21.54%) withdrew from peritoneal dialysis of the 14 cases above, there was one death, with a fatality rate of 1.54%, and 13 cases were converted to hemodialysis after catheter removal. There were no statistically significant differences in cure rate and withdrawal rate between patients with Grampositive bacterial infection and patients with Gramnegative bacterial infection (P>0.05). The two cases with fungal infection were converted to hemodialysis after catheter removal. Conclusion It is necessary to strengthen the health education for patients with PDAP of the peritoneal dialysis center, and to improve the positive rate of dialysate culture.The main pathogenic bacteria of PDAP centers on grampositive bacteria. The combination of the first and the third generation of cephalosporins can still be used as an initial empirical drug for PDAP in the hospital.
Key words: peritoneal dialysis, peritonitis, antimicrobial spectrum, drug resistance
CLC Number:
R459.5
Shi Youshan, Chen Tianhao. Pathogenic bacteria and etiological analysis of peritoneal dialysisassociated peritonitis in a single peritoneal dialysis center[J]. Clinical Focus, 2020, 35(11): 1010-1014.
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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2020.11.011
https://huicui.hebmu.edu.cn/EN/Y2020/V35/I11/1010