發(fā)布時(shí)間：2018-12-06 21:59

【摘要】：目的:分析腹透相關(guān)腹膜炎的病原菌分布,耐藥性情況,為抗菌藥物的合理使用提供依據(jù)。方法:回顧性分析2012年1月-2015年6月入住醫(yī)院的腹透相關(guān)腹膜炎54例次,統(tǒng)計(jì)病原菌分布、敏感性情況及轉(zhuǎn)歸情況。結(jié)果:(1)54例次病原菌培養(yǎng)陽(yáng)性38例次(70.4%),其中革蘭陽(yáng)性菌27例次(71%),以葡萄球菌和鏈球菌居多;革蘭陰性菌10例次(26.3%),以大腸埃希菌最多;真菌1例次(2.6%)。(2)革蘭陽(yáng)性(G+)菌對(duì)復(fù)方磺胺、環(huán)丙沙星、克林霉素、糖肽類敏感率分別是71.4%,74.1%,80%,100%;革蘭陰性(G-)菌對(duì)環(huán)丙沙星、頭孢他啶、阿米卡星、頭孢哌酮舒巴坦、哌拉西林他唑巴坦、亞胺培南敏感率分別是72.7%,81.8%,81.8%,90.9%,90.9%,100%。(3)腹膜炎總體治愈率87%,G+菌治愈率(96.3%)高于革蘭陰性菌治愈率(80%)。(4)重現(xiàn)、復(fù)發(fā)性腹膜炎病原菌敏感性均出現(xiàn)下降。結(jié)論:腹透相關(guān)腹膜炎病原菌以G+菌為主,經(jīng)驗(yàn)治療可選三代頭孢聯(lián)合萬(wàn)古霉素。最終仍要根據(jù)藥敏結(jié)果及時(shí)調(diào)整用藥。
[Abstract]:Objective: to analyze the distribution of pathogens and drug resistance of peritoneal dialysis associated peritonitis and to provide evidence for rational use of antimicrobial agents. Methods: 54 cases of peritoneal dialysis associated peritonitis admitted to hospital from January 2012 to June 2015 were analyzed retrospectively. Results: (1) 38 cases (70.4%) were positive for 54 times of pathogen culture, 27 cases (71%) were Gram-positive bacteria, most were Staphylococcus and Streptococcus, 10 cases (26.3%) were Gram-negative bacteria, the most was Escherichia coli. The sensitivity of gram positive (G) bacteria to compound sulfa, ciprofloxacin, clindamycin and glycopeptide in 1 case (2.6%). (2) was 71.4% and 74.1%, respectively. The sensitivity rate of Gram-positive (G) bacteria to compound sulfamethamide, ciprofloxacin, clindamycin and glycopeptide was 71.4% and 74.1% respectively. The sensitivity rates of gram-negative bacteria to ciprofloxacin, ceftazidime, amikacin, cefoperazone sulbactam, piperacillin tazobactam and imipenem were 72.7%, 81.8% and 81.8%, respectively. (3) the overall cure rate of peritonitis was 87.3%, and the cure rate of Gram-negative bacteria (80%). (_ 4) was higher than that of Gram-negative bacteria (96. 3%), and the susceptibility of pathogenic bacteria to recurrent peritonitis was decreased. Conclusion: G bacteria is the main pathogen of peritoneal dialysis associated peritonitis, and three generations of cephalosporins combined with vancomycin can be treated empirically. Finally, the drug should be adjusted according to the results of drug sensitivity.
【作者單位】： 蘇州大學(xué)附屬第一醫(yī)院藥學(xué)部;南京醫(yī)科大學(xué)第一附屬醫(yī)院藥學(xué)部;南京醫(yī)科大學(xué)附屬南京兒童醫(yī)院藥學(xué)部;蘇州大學(xué)附屬第一醫(yī)院腎內(nèi)科;蘇州大學(xué)附屬第一醫(yī)院檢驗(yàn)科;
【分類號(hào)】：R446.5;R459.5

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