本文選題：腹膜透析 + 腹膜炎�。� 參考：《上海醫(yī)學》2016年03期

【摘要】：目的分析腹膜透析患者發(fā)生腹膜透析相關性腹膜炎(PDAP)的致病菌及其耐藥性,指導臨床合理應用抗菌藥物。方法選取2012年1月—2015年6月同濟大學附屬同濟醫(yī)院腎內科收治的腹膜透析患者資料,其中77例患者并發(fā)PDAP,共發(fā)生PDAP 102例次,回顧性分析其透析液致病菌培養(yǎng)結果、耐藥情況、治療效果和治療轉歸。結果腹膜透析液培養(yǎng)致病菌結果陽性81例次,陰性21例次,細菌培養(yǎng)的陽性率為79.4%,其中革蘭陽性菌感染56例次(69.1%),革蘭陰性菌感染20例次(24.7%),真菌感染2例次(2.5%),2種以上致病菌感染3例次(3.7%)。56例次革蘭陽性菌對青霉素的耐藥率最高(78.6%),其次是紅霉素(48.2%),苯唑西林(42.9%)位居第三,對萬古霉素均敏感;20例次革蘭陰性菌對頭孢唑啉的耐藥率最高(65.0%),對亞胺培南的耐藥率最低(10.0%),對阿米卡星和頭孢他啶的耐藥率分別為25.0%和20.0%;革蘭陽性菌中葡萄球菌屬最多,葡萄球菌屬對苯唑西林的耐藥率較高,達45.0%(18/40,均為凝固酶陰性葡萄球菌),對萬古霉素均敏感。PDAP的總體治愈率為82.4%(84/102),致病菌為革蘭陽性菌腹膜炎的退出率為12.5%(7/56),革蘭陰性菌腹膜炎的退出率為30.0%(6/20),真菌性腹膜炎的退出率為2/2,雙重感染的退出率為2/3,培養(yǎng)陰性的腹膜炎的退出率為4.8%(1/21)。結論 PDAP的致病菌以革蘭陽性菌為主,經(jīng)驗治療應以中心特異性原則選擇合適的抗生素,致病菌的差異是影響其預后的重要因素。
[Abstract]:Objective to analyze the pathogenic bacteria and their drug resistance in peritoneal dialysis patients with peritoneal dialysis associated peritonitis (PDAP) and to guide the rational use of antimicrobial agents. Methods from January 2012 to June 2015, the data of peritoneal dialysis patients in Tongji Hospital affiliated to Tongji University, Tongji University, were selected, 77 of them were complicated with PDAP and 102 times of PDAP. the results of dialysate pathogenic bacteria culture and drug resistance were analyzed retrospectively. Therapeutic effect and outcome. Results 81 positive and 21 negative peritoneal dialysate cultures were positive. The positive rate of bacterial culture was 79.4%, of which 56 cases were Gram-positive bacteria infection, 20 cases were Gram-negative bacteria infection, and 2 cases were fungal infection. The resistance rate of Gram-positive bacteria to penicillin was the highest in 3 cases. 56 cases of Gram-positive bacteria were resistant to penicillin. 78.6%, followed by erythromycin 48.2 and oxacillin 42.9). The resistance rate of 20 gram-negative bacteria to cefazolin was the highest (65.0%), the lowest to imipenem (10.0%), to amikacin and ceftazidime (25.0%) and to ceftazidime (20.0%). The resistance rate of staphylococcus to oxacillin was higher. To 45.0% 18 / 40, all coagulase-negative staphylococci, the overall cure rate for vancomycin sensitive. PDAP is 82.40.84 / 102, for gram-positive peritonitis, 12.5g / 7 / 56, for gram-negative peritonitis, 30.06 / 20, for fungal peritonitis, for gram-negative bacterial peritonitis, for vancomycin, for gram-positive peritonitis, for gram-negative bacterial peritonitis, for coagulase-negative staphylococci. The exit rate was 2 / 2, the exit rate for double infection was 2 / 3, and the exit rate for culture negative peritonitis was 4.8 / 21. Conclusion Gram-positive bacteria are the main pathogens of PDAP. The choice of appropriate antibiotics should be based on the principle of central specificity. The difference of pathogenic bacteria is an important factor affecting the prognosis of PDAP.
【作者單位】： 同濟大學附屬同濟醫(yī)院腎內科;同濟大學附屬同濟醫(yī)院檢驗科;
【基金】：國家自然科學基金資助項目(81370790)
【分類號】：R446.5

【相似文獻】

相關期刊論文 前2條

1 許戎;胡寧;阿榮其其格;李孜;董捷;;腹膜透析相關性腹膜炎單中心8年變化趨勢回顧分析[J];中國血液凈化;2013年01期

2 ;[J];;年期

，

本文編號：1947494