中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2011年
12期
899-902
,共4页
晏焕青%李芸%保永军%唐粼%黄鑫%周国秀%朱彤莹
晏煥青%李蕓%保永軍%唐粼%黃鑫%週國秀%硃彤瑩
안환청%리예%보영군%당린%황흠%주국수%주동형
腹膜透析%腹膜炎%抗药性%抗生素
腹膜透析%腹膜炎%抗藥性%抗生素
복막투석%복막염%항약성%항생소
Peritoneal dialysis%Peritonitis%Drug resistance%Antibiotics
目的 研究华山医院及宝山分院腹膜透析(腹透)相关性腹膜炎的致病菌、耐药性及患者转归,为临床经验用药提供依据.方法 回顾性分析2007年1月至2010年1月上述两医院腹透中心收治的93例腹透相关性腹膜炎的临床表现、致病菌、耐药性及转归.结果 75例腹透液培养阳性,阳性率为80.2％,其中革兰阳性球菌45例,革兰阴性杆菌21例,真菌2例,革兰阳性杆菌1例,革兰阴性球菌1例,多种菌混合感染5例.革兰阳性球菌主要以凝固酶阴性的葡萄球菌为主,所有革兰阳性球菌对万古霉素均敏感,但对头孢唑林耐药率高达60.0％,而且耐药率有明显的逐年增加趋势.革兰阴性菌对头孢他啶的耐药率达到46.1％,所有革兰阴性杆菌对亚胺培南均敏感.因腹膜炎而退出腹膜透析有16例,退出率为17.2％( 16/93).腹腔使用万古霉素对残肾功能无显著影响.结论 两院腹透中心腹透相关腹膜炎致病菌以革兰阳性球菌为多数.头孢唑啉耐药性逐年增高,目前不再适合作为初始治疗的经验用药.腹腔使用万古霉素可推荐作为革兰阳性菌致腹膜炎的初始经验用药.
目的 研究華山醫院及寶山分院腹膜透析(腹透)相關性腹膜炎的緻病菌、耐藥性及患者轉歸,為臨床經驗用藥提供依據.方法 迴顧性分析2007年1月至2010年1月上述兩醫院腹透中心收治的93例腹透相關性腹膜炎的臨床錶現、緻病菌、耐藥性及轉歸.結果 75例腹透液培養暘性,暘性率為80.2％,其中革蘭暘性毬菌45例,革蘭陰性桿菌21例,真菌2例,革蘭暘性桿菌1例,革蘭陰性毬菌1例,多種菌混閤感染5例.革蘭暘性毬菌主要以凝固酶陰性的葡萄毬菌為主,所有革蘭暘性毬菌對萬古黴素均敏感,但對頭孢唑林耐藥率高達60.0％,而且耐藥率有明顯的逐年增加趨勢.革蘭陰性菌對頭孢他啶的耐藥率達到46.1％,所有革蘭陰性桿菌對亞胺培南均敏感.因腹膜炎而退齣腹膜透析有16例,退齣率為17.2％( 16/93).腹腔使用萬古黴素對殘腎功能無顯著影響.結論 兩院腹透中心腹透相關腹膜炎緻病菌以革蘭暘性毬菌為多數.頭孢唑啉耐藥性逐年增高,目前不再適閤作為初始治療的經驗用藥.腹腔使用萬古黴素可推薦作為革蘭暘性菌緻腹膜炎的初始經驗用藥.
목적 연구화산의원급보산분원복막투석(복투)상관성복막염적치병균、내약성급환자전귀,위림상경험용약제공의거.방법 회고성분석2007년1월지2010년1월상술량의원복투중심수치적93례복투상관성복막염적림상표현、치병균、내약성급전귀.결과 75례복투액배양양성,양성솔위80.2％,기중혁란양성구균45례,혁란음성간균21례,진균2례,혁란양성간균1례,혁란음성구균1례,다충균혼합감염5례.혁란양성구균주요이응고매음성적포도구균위주,소유혁란양성구균대만고매소균민감,단대두포서림내약솔고체60.0％,이차내약솔유명현적축년증가추세.혁란음성균대두포타정적내약솔체도46.1％,소유혁란음성간균대아알배남균민감.인복막염이퇴출복막투석유16례,퇴출솔위17.2％( 16/93).복강사용만고매소대잔신공능무현저영향.결론 량원복투중심복투상관복막염치병균이혁란양성구균위다수.두포서람내약성축년증고,목전불재괄합작위초시치료적경험용약.복강사용만고매소가추천작위혁란양성균치복막염적초시경험용약.
Objective To investigate the pathogens,drug resistance and outcomes of continuous ambulatory peritoneal dialysis (CAPD) patients with peritoneal dialysis-related peritonitis in our peritoneal dialysis (PD) centers. Method Data including clinical manifestations,pathogens,treatment,outcome of 93 CAPD cases with peritoneal dialysis-related peritonitis in our peritoneal dialysis (PD) centers were retrospectively analyzed. Results Dialysate culture of 75cases was positive with a positive rate of 80.2％,including 45 cases of gram-positive cocci,21cases of gram-negative bacilli,2 cases of fungi and 5 cases of mixed infection.Coagulase-negative staphylococci were the most common gram-positive cocci.All the gram-positive cocci were sensitive to vancomycin,but the resistance rate to cefazolin was 60.0％ with an increasing tendence year by year.Resistance rate of gram-negative bacilli to ceftazidime was 46.1％.All the gram-negative bacilli were sensitive to imipenem.The withdraw rate of CAPD was 17.2％(16/93) because of peritonitis. No obvious side-effect of peritoneal administration of vancomycin was found.Conclusions Gram-positive cocci are major pathogens in CAPD-related peritonitis.Now cefasolin is not suitable for the empiric initial treatment.Peritoneal administration of vancomycin should be recommended for peritonitis caused by gram-positive cocci.
