Pathogens and risk factors of peritoneal dialysisrelated peritonitis
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R181.3+2

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    Abstract:

    ObjectiveTo investigate the bacterial spectrum and antimicrobial resistance of peritoneal dialysis (PD)related peritonitis, and provide evidence for rational antimicrobial use. MethodsClinical data of 120 patients with PDrelated peritonitis in a hospital from January 2013 to December 2014 were retrospectively analyzed. Results91 cases (75.83%) showed positive result in bacterial culture, 93 pathogenic strains were cultured, including 73 (78.49%) grampositive and 13 (13.98%) gramnegative bacterial strains, the most common grampositive bacteria was Staphylococcus epidermidis (n=38, 40.86%), and the main gramnegative bacteria was Escherichia coli (n=3, 3.23%). Grampositive strains had high resistance rates to penicillin, erythromycin, and oxacillin (93.65%, 69.57%, and 64.41% respectively), while resistance rates to vancomycin and linezolid  were both low (2.90% and 1.47% respectively), and were  sensitive to teicoplanin, tigecycline, and nitrofurantoin. Gramnegative bacteria had high resistance rates to cefazolin, cefuroxime, and ampicillin(50.00%,  37.50%, and 37.50% respectively), but were sensitive to imipenem, tobramycin, and piperacillin. Resistance rates of grampositive and gramnegative bacteria to gentamicin and levofloxacin were both low. Nonstandard operation during dialysate exchange was the most common cause of peritonitis (56.67%), most peritonitis were grampositive bacterial infection(79.41%);while gramnegative bacteria  were the main pathogens of diarrheainduced peritonitis (52.63%). The cure rates of grampositive bacteria, gramnegative bacteria,and negativecultured peritonitis were 92.96%, 76.92%, and 86.21% respectively, difference was not statistically significant(χ2=3.39,P=0.18). ConclusionGrampositive bacteria are major pathogens in PDrelated peritonitis, and are usually caused by the bacteria through  dialysis catheter due to nonstandard operation during dialysate exchange. Firstgeneration cephalosporins are not recommended as empirical therapy against grampositive bacteria, while vancomycin is still the best choice. Thirdgeneration cephalosporins and aminoglycosides are recommended as empirical therapy against gramnegative bacteria. Gentamicin and levofloxacin can be used alone as empirical therapy in special circumstances.

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王静,吕晶,李文冬,等.腹膜透析相关性腹膜炎病原菌及其危险因素[J].中国感染控制杂志英文版,2016,15(10):739-743. DOI:10.3969/j. issn.1671-9638.2016.10.005.
WANG Jing, LV Jing, LI Wendong, et al. Pathogens and risk factors of peritoneal dialysisrelated peritonitis[J]. Chin J Infect Control, 2016,15(10):739-743. DOI:10.3969/j. issn.1671-9638.2016.10.005.

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  • Received:January 28,2016
  • Revised:April 12,2016
  • Adopted:
  • Online: October 26,2016
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