腹膜透析相关性腹膜炎发病因素及耐药特征分析

目的探讨持续性不卧床腹膜透析（CAPD）相关性腹膜炎发生的影响因素和药敏特点。方法从患者性别、年龄、基础疾病、营养状况、致病菌种类以及抗药性方面,回顾性分析我院收治的58例次CAPD相关性腹膜炎病例资料。结果腹膜炎的发生率在40岁以下、无糖尿病、Hb〉90 g/L和Alb〉35 g/L患者显著低于其他患者（P〈0.05）。培养出细菌28例次,阳性率为48.3%,最常见的病原菌为表皮葡萄球菌和金黄色葡萄球菌;革兰阳性菌对利福平、万古霉素耐药率最低;革兰阴性菌对阿米卡星、亚胺培南耐药率最低。结论 CAPD相关性腹膜炎致病菌仍以革兰阳性菌为主,必须根据病原学选择敏感抗生素治疗该病。

Etiological factors and drug resistant characteristics of CAPD-related peritonitis

Objective To investigate the etiological factors and drug sensitivity of continuous-ambulatory-peritoneal-dialysis-related(CAPD)peritonitis.Methods The data of 58 cases with CAPD-related peritonitis in our hospital were retrospectively analyzed from aspects of gender,age,primary disease,nutrition,categories of pathogenic bacteria and drug-resistance.Results The incidence of CAPD-related peritonitis was lower in patients who were under 40 years old,without diabetes and with Hb>90 g/L and Alb>35 g/L(P<0.05).The bacteria were cultured successfully for 28 times with a positive rate of 48.3%.The most common pathogenic bacteria were staphylococcus epidermidis and staphylococcus aureus.Gram-positive bacteria had the lowest drug resistant rate against rifampin and vancomycin.Gram-negative bacteria had the lowest drug resistant rate against amikacin and imipenem.Conclusion Gram-positive bacteria are the predominant pathogenic bacteria causing CAPD-related peritonitis.Sensitive antibiotics should be chosen according to etiologic theory to treat this disease.