腹膜透析相关性腹膜炎的临床特点分析

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题名	腹膜透析相关性腹膜炎的临床特点分析
其他题名	Clinical characteristics of peritoneal dialysis-related peritonitis
作者	金珍木 1; 李素蘋 1; 朱小春2
发表日期	2014-03-20
发表期刊	中华医院感染学杂志影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	腹膜透析腹膜炎临床特点
摘要	目的探讨腹膜透析相关性腹膜炎的临床特点,提高患者的临床疗效,从而降低相关性腹膜炎的发生率。方法随机选取医院2009年8月-2013年2月收治的腹膜透析相关性腹膜炎93例患者,对其进行细菌培养,观察多重感染性腹膜炎的例数,采用法国生物梅里埃公司AKB法进行病原菌鉴定及对抗菌药物敏感试验,分析患者的转归,采用SPSS 13.0软件进行数据统计。结果在93例感染患者中发生多重感染性腹膜炎共24例,占25.8%,其中有2例为两种真菌感染、5例为真菌与革兰阳性菌混合感染、2例为真菌与革兰阴性菌混合感染、4例为两种革兰阳性菌感染、3例为单纯两种革兰阴性菌感染、6例为革兰阳性菌与革兰阴性菌混合感染;对革兰阳性菌最敏感的为万古霉素,敏感率达100.0%,其次是利福平和加替沙星,均为94.0%;对革兰阴性菌最敏感的为美罗培南,敏感率为100.0%,常规用药如庆大霉素和头孢他啶的敏感性较低,分别为64.0%和55.0%,抗菌药物对真菌的敏感率均较好;24例多重感染性腹膜炎患者中17例继续进行腹膜透析,占70.8%,5例退出腹膜透析并改为血液透析治疗,占20.8%,2例死亡,病死率8.4%;在其余69例单一性腹膜炎感染患者中,57例继续进行腹膜透析,占82.6%,10例退出腹膜透析改为血液透析继续治疗,占14.5%;2例死亡,病死率2.9%。结论研究腹膜透析相关性多重感染性腹膜炎的临床特点,包括主要致病菌及其对抗菌药物的敏感性、发病患者的转归,可以有效预防腹膜透析相关性多重感染性腹膜炎的发生,且为临床用药提供理论依据。
其他摘要	OBJECTIVE To explore the clinical characteristics of peritoneal dialysis-related peritonitis and improve the clinical efficacy so as to reduce the incidence of peritoneal dialysis-related peritonitis.METHODS A total of 93 patients with peritoneal dialysis-related peritonitis,who were treated in the hospital from Aug 2009to Feb 2013, were enrolled in the study,then the bacterial culture was conducted,the number of the cases of multiple infectious peritonitis was observed,the identification of pathogens was carried out by using AKB method of BioMerieux, France,the drug susceptibility testing was performed,the prognosis was analyzed,and the statistical analysis was performed with the use of SPSS 13.0software.RESULTS Of the 93patients with infections,the multiple infectious peritonitis occurred in 24cases with the incidence of 25.8%,including 2cases of fungal infections,5cases of mixed infections with fungi and gram-positive bacteria,2cases of mixed infections with fungi and gram-negative bacteria,4cases of infections caused by two species of gram-positive bacteria,3cases of infections caused by two species of gram-negative bacteria,and 6cases of mixed infections with gram-positive bacteria and gram-negative bacteria.The drug susceptibility rate of the gram-positive bacteria to vancomycin was the highest(100.0%),followed by rifampicin(94.0%)and gatifloxacin(94.0%);the drug susceptibility rate of the gram-negative bacteria to meropenem was the highest(100.0%),and the drug susceptibility rates to the commonly used antibiotics such as gentamicin and ceftazidime were 64.0%and 55.0%,respectively;the fungi were highly susceptible to the antibiotics. Of the 24patients with multiple infectious peritonitis,17patients underwent the peritoneal dialysis, accounting for 70.8%,5cases quit the peritoneal dialysis and changed to hemodialysis,accounting for 20.8%, and 2cases died with the mortality rate of 8.4%.Among the 69patients with single peritonitis,57cases underwent the peritoneal dialysis,accounting for 82.6%,10cases quit the peritoneal dialysis and changed to hemodialysis, accounting for 14.5%,and 2cases died with the mortality rate of 2.9%.CONCLUSIONThe peritoneal dialysis- related multiple infectious peritonitis can be effectively prevented through the study of the clinical characteristics, including the distribution of main pathogens,drug susceptibility,and prognosis,which can provide theoretical basis for clinical use of antibiotics.
资助项目	浙江省温州市科技计划基金项目（Y20080191）
ISSN	1005-4529
卷号	24 期号:06 页码:1435-1437
页数	3
收录类别	CNKI ; 北大核心 ; CSCD
学科领域	医药、卫生 ; 内科学
URL	查看原文
CSCD记录号	CSCD:5095752
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/52272
专题	附属第一医院_风湿免疫科附属第一医院
作者单位	1.温州医科大学定理临床学院肾内风湿免疫科; 2.温州医科大学附属第一医院风湿免疫科
第一作者单位	温州医科大学
推荐引用方式 GB/T 7714	金珍木,李素蘋,朱小春. 腹膜透析相关性腹膜炎的临床特点分析[J]. 中华医院感染学杂志,2014,24(06):1435-1437.
APA	金珍木, 李素蘋, & 朱小春. (2014). 腹膜透析相关性腹膜炎的临床特点分析. 中华医院感染学杂志, 24(06), 1435-1437.
MLA	金珍木,et al."腹膜透析相关性腹膜炎的临床特点分析".中华医院感染学杂志 24.06(2014):1435-1437.

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