摘要
Abstract
Objective To investigate the species and drug resistance of pathogenic bacteria causing enterogenous peritoneal dialysis - related peritonitis and analyze the risk factors in order to provide guidance for the rational clinical use of antibacterial agents. Methods From January 2010 to September 2014,we enrolled 143 patients who underwent regular peritoneal dialysis in Shaoxing People' s Hospital. According to whether enterogenous peritoneal dialysis - related peritonitis occurred,the patients were divided into two groups:peritonitis group(n = 24)and control group(n = 119). The general data of patients were collected; the results of the identification of enterogenous bacteria and drug resistance analysis were recorded. Logistic regression analysis was conducted to explore the risk factors for enterogenous peritoneal dialysis - related peritonitis. Results The two groups were significantly different in age,the levels of Hb,Alb and hs-CRP and the rate of diabetics(P < 0. 05). There were 27 episodes of enterogenous bacterial infection in the 24 patients of peritonitis group;the most common bacterial species was escherichia coli(13 episodes,48. 2% ),and the second most common bacterial species was enterococcus faecalis(5 episodes,18. 5% ). The drug resistance rates to ampicillin,levofloxacin,cefazolin,ceftazidime, penicillin and erythrocin were > 50. 0% ,and the resistance rates to amikacin,cefoperazone - sulbactam,piperacillin -tazobactam and teicoplanin were ≤20. 0% . None of the strains were resistant to imipenem or vancomycin. Logistic regression analysis showed that higher age,lower Alb level,higher hs-CRP level and the combination with diabetics were risk factors for enterogenous peritoneal dialysis - related peritonitis(P < 0. 05). Conclusion Enterogenous bacteria are mainly escherichia coli and enterococcus faecalis,and their durg resistance rates are high. For patients with risk factors for enterogenous peritoneal dialysis - related peritonitis(higher age,lower Alb level,higher hs-CRP level and combination with diabetics),we suggest that vancomycin plus amikacin should be the initial treatment plan.关键词
腹膜炎/腹膜透析/肠道细菌/耐药性/危险因素Key words
Peritonitis/Peritoneal dialysis/Enteric bacteria/Drug resistance/Risk factors分类
医药卫生
