[1]刘美岑 邱付兰 张 宇 李小林.腹膜透析相关性腹膜炎临床调查分析[J].福建医药杂志,2020,42(04):140-143.
　LIU Meicen,QIU Fulan,ZHANG Yu,et al.Clinical investigation and analysis of peritioneal dialysis-associated peritionitis[J].FUJIAN MEDICAL JOURNAL,2020,42(04):140-143.
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腹膜透析相关性腹膜炎临床调查分析()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
42
期数:
2020年04期
页码:
140-143
栏目:
调查报告
出版日期:
2020-08-20

文章信息/Info

Title:
Clinical investigation and analysis of peritioneal dialysis-associated peritionitis
文章编号:
1002-2600(2020)04-0140-04
作者:
刘美岑1 邱付兰2 张 宇3 李小林4; 5
福建医科大学附属龙岩第一医院(龙岩 364000)
Author(s):
LIU Meicen; QIU Fulan;  ZHANG Yu;  LI Xiaolin.
Longyan First Hospital Affiliated to Fujian edical University,Longyan,Fujian 364000, China
关键词:
腹膜透析;  腹膜炎;  病原菌;  药敏试验;  抗菌药物
Keywords:
peritoneal dialysis;  peritonitis;  pathogenic bacteria;  drug resistance;  antibiotics
分类号:
R459.5
文献标志码:
B
摘要:
目的 研究腹膜透析相关性腹膜炎(PDAP)患者的病原菌分布、药敏结果、用药情况及转归,为临床用药提供依据。方法 回顾性分析2016年1月至2018年12月在龙岩市第一医院行腹膜透析治疗时发生腹膜透析相关性腹膜炎的165例患者的腹透液病原菌、药敏结果、用药情况及转归。结果 我院PDAP的病原菌主要为革兰阳性菌,占45.45%。革兰阳性菌中,金黄色葡萄球菌和凝固酶阴性葡萄球菌对苯唑西林的耐药率分别为68.75%、69.57%,对万古霉素的耐药率均为0。革兰阴性菌中,大肠埃希菌对头孢曲松、头孢噻肟和头孢他啶的耐药率分别为33.33%、33.33%和14.29%,对阿米卡星的耐药率为0.00%; 肺炎克雷伯氏菌对头孢噻肟和阿米卡星的耐药率为0。留腹抗感染治疗总有效率为84.85%。我院大部分患者留腹治疗疗程在2～3周。结论 我院PDAP的病原菌主要为革兰阳性菌。针对葡萄球菌属引起的PDAP,因我院耐甲氧西林葡萄球菌检出率高,一代头孢不推荐使用,可选用糖肽类抗菌药物如万古霉素作为该类菌属的经验用药。革兰阴性菌中,可经验性选用氨基糖苷类治疗肠杆菌属引起的PDAP。留腹给药为我院治疗PDAP的首选途径。针对腹膜透析相关性腹膜炎的治疗疗程,建议2～3周的留腹抗生素治疗。
Abstract:
Objective To investigate the distribution of pathogenic bacteria, drug resistance, substance use and recovery of peritoneal dialysis(PDAP)patients with peritoneal dialysis-related peritonitis in Longyan First Hospital, and the basis for clinical medication was obtained to provide. Methods The pathogens, drug resistance and recovery of 165 patients with peritoneal dialysis-related peritonitis in our hospital from January 2016 to December 2018 were analyzed retrospectively. Results The pathogenic bacteria of PDAP in our hospital was mainly gram-positive bacteria, accounting for 45.45%. Among gram-positive bacteria, the drug resistance rates of staphylococcus aureus and coagulase-negative staphylococcus to oxacillin were 68.75% and 69.57%, respectively,and the drug resistance rates to vancomycin were 0. Among gram-negative bacteria, the drug resistance rates of escherichia coli to ceftriaxone, cefotaxime and ceftazidime were 33.33%, 33.33% and 14.29%, respectively, and the drug resistance rate of amikacin was 0. The drug resistance rate of klebsiella pneumoniae to cefotaxime and amikacin was 0. The total effective rate was 84.85%. The abdominal treatment course of most patients in our hospital was 2-3 weeks. Conclusion The pathogenic bacteria of PDAP in our hospital are mainly gram-positive bacteria. For PDAP caused by staphylococcus, due to the high detection rate of methicillin-resistant staphylococcus in our hospital, the first-generation cephalosporin is not recommended, and glycopeptide antimicrobial drugs such as vancomycin can be selected as the empirical drug for this type of bacteria. Among gram-negative bacteria, aminoglycosides can be empirically selected to treat enterobacterium-induced PDAP. Abdominal administration is the first choice for PDAP treatment in our hospital. For the abdominal treatment course of peritoneal dialysis-associated peritonitis, antibiotics for 2-3 weeks are recommended.

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备注/Memo

备注/Memo:
1 药剂科临床药学室; 2 微生物室; 3 肾内科; 4 肾内科; 5 通信作者
更新日期/Last Update: 2020-08-20