摘要
目的:分析腹透相关腹膜炎的病原菌分布,耐药性情况,为抗菌药物的合理使用提供依据。方法:回顾性分析2012年1月-2015年6月入住医院的腹透相关腹膜炎54例次,统计病原菌分布、敏感性情况及转归情况。结果:(1)54例次病原菌培养阳性38例次(70.4%),其中革兰阳性菌27例次(71%),以葡萄球菌和链球菌居多;革兰阴性菌10例次(26.3%),以大肠埃希菌最多;真菌1例次(2.6%)。(2)革兰阳性(G+)菌对复方磺胺、环丙沙星、克林霉素、糖肽类敏感率分别是71.4%,74.1%,80%,100%;革兰阴性(G-)菌对环丙沙星、头孢他啶、阿米卡星、头孢哌酮舒巴坦、哌拉西林他唑巴坦、亚胺培南敏感率分别是72.7%,81.8%,81.8%,90.9%,90.9%,100%。(3)腹膜炎总体治愈率87%,G+菌治愈率(96.3%)高于革兰阴性菌治愈率(80%)。(4)重现、复发性腹膜炎病原菌敏感性均出现下降。结论:腹透相关腹膜炎病原菌以G+菌为主,经验治疗可选三代头孢联合万古霉素。最终仍要根据药敏结果及时调整用药。
OBJECTIVE To analyze characteristics,distribution and sensitivity of pathogenic organisms,provide a reference for rational use of antibiotics.METHODS A total of 42 patients with peritoneal dialysis related peritonitis hospitalized from January 2012 to June 2015 were enrolled in this study.Distribution,drug sensitivity and outcomes were retrospectively analyzed for pathogenic bacteria.RESULTS In 54 samples for microbial culture,38samples（70.4%）were positive for pathogens,including gram-positive bacteria in 27cases（71%）,gram-negative bacteria in 10cases（26.3%）,and fungi in 1case（2.6%）.In isolated gram-positive bacteria,antibiotic sensitive rate to cotrimoxazole,ciprofloxacin,clindamycin,glycopeptides were 71.4%,74.1%,80% and 100%,respectively.In isolated gram-negative bacteria,antibiotic sensitive rates to ciprofloxacin,ceftazidime,amikacin,cefoperazone-sulbactam,piperacillin-tazobactam,imipenem,were 72.7%,81.8%,81.8%,90.9%,90.9% and 100%,respectively.Recovery rates were 87%,96.3%,80%and 81.2%in all patients,and patients with gram-positive,gram-negative,and microbial-negative peritonitis.Sensitivity of bacteria in repeated and relapsed peritonitis were declined.CONCLUSIONGram positive bacteria are predominant pathogens causing PD-related peritonitis.The third generation of cephalosporins combined with vancomycin can be used as empirical therapy,and it is necessary to adjust drug therapy and reasonably use antibiotics on basis of drug susceptibility test.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2016年第9期762-765,共4页
Chinese Journal of Hospital Pharmacy
关键词
腹透相关性腹膜炎
病原菌
敏感性
peritoneal dialysis related peritonitis
pathogen
sensitivity
