腹膜透析相关性腹膜炎的病原学及耐药分析

目的分析持续非卧床腹膜透析相关性腹膜炎的致病菌及耐药性,探索腹膜炎的防治方案。方法回顾性分析80例次持续非卧床腹膜透析患者发生腹膜炎的临床表现、致病菌、耐药性和转归情况。结果 51例透析液培养阳性,阳性率为63.7%,其中36例为革兰阳性菌,12例为革兰阴性菌,3例真菌。表皮葡萄球菌所占比例最高(19.61%),其次为金黄色葡萄球菌和大肠杆菌,分别占11.76%和7.84%。结论革兰阳性菌仍为腹膜透析相关性腹膜炎的重要病原菌,以表皮葡萄球菌、金黄色葡萄球菌为主。青霉素类及头孢菌素类抗生素在G+病原菌中已有较高耐药率,应减少或避免其使用。

Pathogens and drug resistance analysis of peritoneal dialysis-associated peritonitis

Objective To analyze the pathogens and drug-resistance of peritonitis in continuous ambulatory peritoneal dialysis patients and explore the control and management of peritonitis.Methods The clinical manifestation,pathogens,resistance to drugs and outcomes of 80 continuous ambulatory peritoneal dialysis patients with peritonitis were analyzed retrospectively.Results The specimen numbers of positive culture fluid were 51（63.7%）.36 cases were Gram-positive cocci,12 cases were Gram-negative bacilli and 3 were fungi.Among them,Staphylococcus Epidermidis was the most,accounted for 19.61%,followed by Staphylococcus Aureus （11.76%） and Escherichia coli （7.84%）.Conclusion Gram-positive cocci were still the predominant pathogens of peritoneal dialysis-associated peritonitis,and most of them were Staphylococcus Epidermidis and Staphylococcus Aureus.Gram-positive cocci showed high resistance to penicillins and cephalosporins,so we should avoid the usage of these antibiotics or use them less.