摘要
目的探讨腹膜透析相关性腹膜炎的致病菌及其对药物的敏感性。方法回顾性分析郑州大学第一附属医院腹膜透析中心2006～2009年间收治的85例次持续不卧床腹膜透析（CAPD）相关性腹膜炎患者的致病菌及药敏试验结果。结果85例次cAPD引流液培养中，58例次（68．2％）培养阳性，致病菌中革兰阳性球菌34例次（58．6％），革兰阴性杆菌18例次（31．1％），真菌6例次（10．3％）。药敏试验结果表明，革兰阳性球菌对头孢唑啉耐药率达61．8％，对万古霉素和亚胺培南的耐药率均为2．9％。革兰阴性杆菌对庆大霉素耐药率达50．0％，对亚胺培南耐药率为5．6％。腹膜炎的退出率为23．5％。结论CAPD相关腹膜炎致病菌仍以革兰阳性球菌为主，但革兰阴性杆菌及真菌所致腹膜炎比例有上升趋势。致病菌对头孢唑啉和庆大霉素的耐药率较高，对亚胺培南和万古霉素的耐药率较低可作为经验用药。
Objective To investigate the pathogens and their drug sensitivity in peritoneal dialysis-related peritonitis. Methods Pathogens and drug susceptibility test results of 85 cases of continuous ambulatory peritoneal dialysis（CAPD）-related peritonitis were analyzed retrospectively. Results Among 85 cases of CAPD drainage fluid culture,58 cases were cultured positive with a positive rate of 68.2%, including 34 cases of gram-positive cocci （58.6 % ）, 18 cases of gram-negative bacilli （31.1% ）, and 6 cases of fungi （10.3 % ）. Drug sensitivity test results showed that gram-positive cocci showed a high resistance rate of 61.8% to cefazolin and a low resistance rate of 2, 9% to vancomycin or imipenem. 50.0% of gram-negative bacilli were resistant to gentamycin. There was a low resistance rate of 5.6% to imipenem. The total CAPD withdrawal rate in peritonitis was 23.5%. Conclusion Gram-positive cocci is still the main pathogen in CAPD related-peritonitis, but there is an increasing proportion of peritonitis caused by gram-negative bacteria and fungal. There is a high resistance rate to cefazolin or gentamycin and a low resistance to vancomycin or imipenem. Therefore, vancomycin and imipenem can be used as empiric therapy for CAPD related peritonitis.
出处
《临床荟萃》
CAS
2010年第5期405-408,共4页
Clinical Focus
关键词
腹膜透析
腹膜炎
细菌
抗菌药
peritoneal dialysis
peritonitis
bacteria
anti-bacterial agents
作者简介
通信作者：赵占正，Email：13938525666@139．com
