CAJ | 학술논문

目的：分析腹膜透析相关性腹膜炎( PDAP)的病原菌分布特点及药敏试验，为PDAP的临床防治提供依据。方法采集2011年1月至2014年1月收治的67例PDAP患者的腹膜透析引流液进行细菌培养，采用API系统鉴定菌株，并采用K-B琼脂法行药敏试验。结果60例培养阳性，阳性率为89．55%，单一感染48例，混合感染12例；共检出72株菌株，其中革兰阳性菌46株，占63．89%，以葡萄球菌属为主；革兰阴性菌23株，占31．94%，以大肠埃希菌为主；真菌3株，占4．17%。革兰阳性菌对万古霉素、利奈唑胺的敏感率均为100．00%；革兰阴性菌对亚胺培南的敏感率为100．00%。治疗后67例患者治愈率71．64%，转血液透析率11．94%，拔管率13．43%，死亡率2．99%。结论 PDAP病原菌分布复杂，且病原菌分布存在性别、季节差异，临床应根据细菌培养及药敏试验选择高敏抗菌药物治疗。
목적：분석복막투석상관성복막염( PDAP)적병원균분포특점급약민시험，위PDAP적림상방치제공의거。방법채집2011년1월지2014년1월수치적67례PDAP환자적복막투석인류액진행세균배양，채용API계통감정균주，병채용K-B경지법행약민시험。결과60례배양양성，양성솔위89．55%，단일감염48례，혼합감염12례；공검출72주균주，기중혁란양성균46주，점63．89%，이포도구균속위주；혁란음성균23주，점31．94%，이대장애희균위주；진균3주，점4．17%。혁란양성균대만고매소、리내서알적민감솔균위100．00%；혁란음성균대아알배남적민감솔위100．00%。치료후67례환자치유솔71．64%，전혈액투석솔11．94%，발관솔13．43%，사망솔2．99%。결론 PDAP병원균분포복잡，차병원균분포존재성별、계절차이，림상응근거세균배양급약민시험선택고민항균약물치료。
Objective To analyze the pathogen distribution and susceptibility test of PDAP and provide refer-ence for the prevention and treatment of PDAP. Methods Peritoneal dialysis fluid drainage of 67 cases of PDAP from January 2011 to January 2014 were collected,and the API system and K-B agar line were used for bacterial culture and strains identification and drug susceptibility test. Results There were 60 cases of culture-positive(89. 55%),48 cases of single infection,12 cases of mixed infection;46 strains gram-positive bacteria were detected in 72 strains(63. 89%), mainly as staphylococcus;gram negative bacteria were 23 strains(31. 94%),mainly as Escherichia coli;fungus were 3 strains(4. 17%). The linezolid-sensitive rate of gram-positive bacteria to vancomycin was 100. 00%;The sensitivity of gram-negative bacteria to imipenem was 100. 00%. After treatment,the curative rate of 67 patients was 71. 64%,hemo-dialysis transfer rate was 11. 94%,extubation rate was 13. 43%,mortality rate was 2. 99%. Conclusion PDAP patho-gen distribution is complex,with gender distribution and seasonal differences,it should be based on clinical bacterial culture and sensitivity test to select high-sensitivity antibiotic therapy.