摘要
目的探讨多频次腹透相关性腹膜炎的临床特点、病原分布及耐药情况。方法回顾性分析2013年1月-2017年7月间因腹透相关性腹膜炎入院的腹膜透析患者,入院次数≥2者列为多频次组,仅1次入院者列为单次组。结果多频次组23例,发生腹膜炎54例次,单次组18例,发生腹膜炎18例次。两组间性别、腹透龄、血压、血肌酐、血尿素氮、血钾、血钙、血磷及病原分布差异无统计学意义(P>0.05)。与单次组相比,多频次组患者的年龄普遍较大、原发病多为糖尿病肾病,而血红蛋白及血清白蛋白水平偏低(P<0.05)。主要致病菌为革兰阴性菌,以大肠埃希菌居多,对氨曲南、头孢唑啉、头孢曲松的耐药率最高,对哌拉西林/他唑巴坦及亚胺培南敏感;革兰阳性菌以表皮葡萄球菌为主,对氨苄青霉素、苯唑西林及克林霉素耐药,对万古霉素和莫西沙星敏感。结论腹透相关性腹膜炎的反复出现与患者年龄大、有糖尿病、贫血及低白蛋白血症病史相关。
Objective To discuss the clinical characteristics,pathogen distribution and drug resistance of frequent peritoneal dialysis-associated peritonitis（PDAP）.Methods Retrospective analysis was performed on the clinical data of patients with PDAP admitted in our hospital during January 2013 and July 2017.The patients were divided into M group（times of hospitalization1）or S group（times of hospitalization=1）.Results The 23 patients in M group occurred 54 episodes of peritonitis,while the 18 patients in S group occurred 18 episodes of peritonitis.There were no statistically significant differences between the two groups（P〈0.05）in gender,number of years of peritoneal dialysis,blood pressure,blood creatinine,blood urea nitrogen,potassium,calcium,phosphorus and distribution of pathogens.Compared with the S group,the patients in M group were generally elder and had a higher incidence of diabetic nephropathy;their levels of hemoglobin and serum albumin were lower（P〈0.05）.The major pathogenic bacteria were Gram-negative bacteria with E.coli ranking the first.They showed the highest drug resistance rates to aztreonam,cefazolin and ceftriaxone,while were sensitive to piperacillin/tazobactam and imioenem.In the Gram-positive bacteria,Staphylococcus epidermis was predominant,which was resistant to ampicillin,benzoxicillin and clindamycin,while sensitive to vancomycin and moxifloxacin.Conclusion The recurrence of PDAP is associated with age and histories of diabetes,anemia and hypoalbuminemia.
出处
《中国微生态学杂志》
CAS
CSCD
2018年第2期193-196,共4页
Chinese Journal of Microecology
关键词
腹透相关性腹膜炎
糖尿病
贫血
低白蛋白血症
病原菌
Peritoneal dialysis-associated peritonitis
Diabetes
Anemia
Hypoalbuminemia
Pathogenic bacteria
