中国感染控制杂志2025，Vol.24Issue(3)：381-387,7.DOI:10.12138/j.issn.1671-9638.20255327
铜绿假单胞菌所致腹膜透析相关性腹膜炎临床特征及预后
Clinical characteristics and prognosis of Pseudomonas aeruginosa perito-neal dialysis-associated peritonitis
摘要
Abstract
Objective To analyze the clinical characteristics and prognosis of Pseudomonas aeruginosa peritoneal dialysis-associated peritonitis(PaeP).Methods Peritoneal dialysis-associated peritonitis(PDAP)patients who were followed up in the nephrology outpatient department of a hospital from January 2019 to December 2020 were analyzed retrospectively.According to bacterial culture results,patients were divided into the PaeP group and non-PaeP group.Clinical characteristics of PaeP patients and antimicrobial susceptibility testing results of Pseudomonas aeruginosa were analyzed,clinical manifestations,laboratory test results,and prognosis of two groups of patients were compared.Results A total of 124 peritoneal dialysis patients were included in analysis,164 cases of peritoni-tis occurred,16 cases were in the PaeP group and 148 in the non-PaeP group.11 patients developed 16 episodes of Pseudomonas aeruginosa infection,accounting for 8.9％of PDAP patients.Among them,4 patients had peritoneal dialysis catheter exit-site infection,with 5 recurrence cases,1 case cured,1 case died,and 9 cases were extubated.Among the extubated patients,1 withdrew dialysis,3 were recovered to peritoneal dialysis after hemodialysis,5 changed to permanently hemodialysis,with a technical failure rate of 54.5％.Compared with the non-PaeP group,patients in the PaeP group had a shorter dialysis time(13.83±4.92 vs 38.53±35.77 months).During the infection period,C-reactive protein levels were higher(96.61±6.17 vs 45.87±44.65 mg/L),while albumin levels were lower(25.62±4.42 vs 29.46±8.25 g/L).At the onset of infection,the proportion of polymorphonuclear cells in perito-neal dialysis fluid was relatively higher.On the 5th day of treatment,the negative conversion rate of white blood cell count in peritoneal dialysis fluid was relatively low.Differences were all statistically significant(all P＜0.05).The cure rate of patients in the PaeP group was lower than that in the non-PaeP group,the technical failure rate was higher than that in the non-PaeP group,both with statistically significant differences(both P＜0.05).There was no statistically significant difference in the mortality between two groups of patients(P＞0.05).Conclusion PaeP patients have severe clinical manifestations,poor clinical treatment prognosis,high recurrence and extubation rates.For patients with repeated episodes,resetting and replacing the tunnel after extubation is an effective means to re-duce technical failures.关键词
腹膜透析相关性腹膜炎/铜绿假单胞菌腹膜透析相关性腹膜炎/铜绿假单胞菌/经验性治疗/技术失败Key words
peritoneal dialysis-associated peritonitis/Pseudomonas aeruginosa peritoneal dialysis-associated peri-tonitis/Pseudomonas aeruginosa/empirical treatment/technical failure分类
临床医学引用本文复制引用
王志刚,耿瀛洲,王晓培,李昭,梁嫦娜,路万虹,吕晶..铜绿假单胞菌所致腹膜透析相关性腹膜炎临床特征及预后[J].中国感染控制杂志,2025,24(3):381-387,7.基金项目
陕西省重点研发计划项目(2021SF-070) （2021SF-070）
西安交通大学第一附属医院临床科研课题面上项目(XJTU1AF-CRF-2019-017) （XJTU1AF-CRF-2019-017）
