腹膜透析相关性腹膜炎的细菌学及耐药性分析

目的观察腹膜透析相关性腹膜炎的病原菌及耐药性。方法调查分析56例次腹膜透析相关性腹膜炎的病因、细菌学及细菌耐药情况。结果①引发腹膜炎的主要原因是无菌操作不严格（39.3%）和肠道感染（37.5%）。②本研究56例次PD相关性腹膜炎病例有37例次进行了细菌学培养,其中阳性35例次,阳性率达94.6%。所有致病菌中革兰氏阳性菌为28例次,占80%;革兰氏阴性菌为6例次,占17.1%;真菌1例,占2.9%。③在28例次革兰氏阳性菌的药敏试验中,红霉素（90.91%）、头孢唑林（85.71%）、青霉素（77.78%）为耐药率最高的三种抗生素,阿莫西林（0.0%）、替考拉宁（0.0%）、万古霉素（5.0%）为三种最敏感的抗生素。在6例次革兰氏阴性菌的药敏试验中,耐药率最高（100%）的有妥布霉素、氨曲南、头孢唑林、青霉素,而敏感的抗生素则较多。④56例次病人经抗感染治疗后,49例次（87.5%）治愈,6例（10.7%）死亡,1例（1.8%）转为血液透析。结论强化无菌操作观念和及时治疗肠道感染是有效的腹膜透析相关性腹膜炎预防措施,病原菌的种类仍以革兰氏阳性菌为主,未发现特殊耐药菌出现。

Analysis of pathogens and anti-microbial susceptibilities on peritoneal dialysis-related peritonitis

Objective To investigate the pathogens and their anti-microbial susceptibilities in peritoneal dialysis-related peritonitis.Methods The possible causes,bacteriology and anti-microbial susceptibility test results of 56 cases of continuous ambulatory peritoneal dialysis(CAPD) were retrospectively analyzed.Results Not strictly aseptic operation and intestinal infection were the most common causes of peritonitis;Among 56 cases of PD-related peritonitis,drainage fluid culture were carried out in 37cases among wh...