摘要
目的分析腹膜透析相关性腹膜炎的病原菌谱特点及耐药情况。方法回顾性分析2013年1月至2020年12月在本院收治的49例腹膜透析相关性腹膜炎患者的临床资料,分析其病原菌谱及药敏结果。结果腹透液培养阳性32例(65.31%),其中革兰阳性菌15例(46.88%)、革兰阴性菌15例(46.88%)、真菌2例(6.25%)。革兰阳性菌以表皮葡萄球菌为主,革兰阴性菌以大肠埃希菌为主。革兰阴性菌对碳青霉烯类、阿米卡星、哌拉西林他唑巴坦、头孢哌酮钠舒巴坦钠、莫西沙星、替加环素均敏感,对头孢唑林、头孢他啶、环丙沙星、左氧氟沙星的耐药率分为别33.33%、14.29%、16.67%、21.43%。革兰阳性菌对替加环素、利奈唑胺、环丙沙星、左氧氟沙星、莫西沙星均敏感,对万古霉素和利福平的耐药率均为7.14%,对庆大霉素的耐药率16.67%。共治愈36例(73.47%),其中革兰阳性菌初始方案的治愈率高于革兰阴性菌,差异有统计学意义(P<0.05)。腹透液培养革兰阴性菌患者的血白蛋白高于腹透液培养革兰阳性菌患者,差异有统计学意义(P<0.05)。腹透液培养革兰阳性菌患者的腹透液细胞数转阴天数少于腹透液培养革兰阴性菌患者,差异有统计学意义(P<0.05)。结论革兰阳性菌和革兰阴性菌均为本中心腹膜透析相关性腹膜炎的主要病原菌,治疗上调整初始治疗方案为万古霉素或喹诺酮类覆盖革兰阳性菌,阿米卡星覆盖革兰阴性菌,提高腹透液中病原菌的检出率。
Objective To analyze the pathogen spectrum characteristics and drug resistance of peritoneal dialysis-related peritonitis.Methods The clinical data of 49 patients with peritoneal dialysis-related peritonitis admitted to our hospital from January 2013 to December 2020 were retrospectively analyzed,and the pathogenic bacteria spectrum and drug sensitivity results were analyzed.Results Peritoneal dialysis fluid culture was positive in 32 cases(65.31%),including 15 cases(46.88%)of Gram-positive bacteria,15 cases(46.88%)of Gram-negative bacteria,and 2 cases(6.25%)of fungi.Staphylococcus epidermidis was the main gram-positive bacteria,and Escherichia coli was the main gram-negative bacteria.Gram-negative bacteria were sensitive to carbapenems,amikacin,piperacillin tazobactam,cefoperazone sodium and sulbactam sodium,moxifloxacin and tigecycline,and the drug resistance rates were cefazolin 33.33%,ceftazidime 14.29%,ciprofloxacin 16.67%and levofloxacin 21.43%,respectively.Gram-positive bacteria were sensitive to tigecycline,linezolid,ciprofloxacin,levofloxacin and moxifloxacin.The resistance rate to vancomycin and rifampicin was 7.14%,and the resistance rate to gentamicin was 16.67%.A total of 36 cases(73.47%)were cured,and the cure rate of the initial regimen of Gram-positive bacteria was higher than that of Gram-negative bacteria,the difference was statistically significant(P<0.05).The serum albumin of Gram-negative bacteria cultured in peritoneal dialysis was higher than that of Gram-positive bacteria cultured in peritoneal dialysis,and the difference was statistically significant(P<0.05).The number of negative days of peritoneal dialysis cells cultured with Gram-positive bacteria was less than that of Gram-negative bacteria cultured with peritoneal dialysis,and the difference was statistically significant(P<0.05).Conclusions Both gram-positive bacteria and gram-negative bacteria are the main pathogens of peritoneal dialyzation-related peritonitis in our center.It is recommended to adjust the initial treatment regimen
作者
郑佳麒
沈明静
刘玺
丘友谊
郭明艳
Zheng Jiaqi;Shen Mingjing;Liu Xi;Qiu Youyi;Guo Mingyan(Department of Nephrology,Longgang Central Hospital,Shenzhen 518000,China)
出处
《国际泌尿系统杂志》
2022年第5期902-905,共4页
International Journal of Urology and Nephrology
关键词
腹膜透析
腹膜炎
病原菌
Peritoneal Dialysis
Peritonitis
Pathogenic Bacterium
