肠道感染所致腹膜透析患者相关性腹膜炎致病菌及耐药性分析  

Pathogens of peritonitis caused by intestinal infection in patients with peritoneal dialysis and their drug resistance

作　　者：张灵灵 郭利芹 陶瑾[1] 徐可[1] 韩晓静[1] ZHANG Ling-ling;GUO Li-qin;TAO Jin;XU Ke;HAN Xiao-jing(Xinxiang Central Hospital,Xinxiang,Henan 453000,China)

机构地区：[1]新乡市中心医院肾内科,河南新乡453000

出　　处：《中华医院感染学杂志》2018年第24期3767-3770,共4页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关计划基金资助项目(201203144)

摘　　要：目的分析肠道感染所致腹膜透析患者相关性腹膜炎的致病菌和耐药性。方法选取2014-2017年于医院接受诊治的100例相关性腹膜炎患者作为研究对象,培养分离其致病菌,并观察耐药情况;对比记录2014-2017年与2000-2003年腹膜炎患者治疗总有效率及导管拔除与病死率。结果 100例相关性腹膜炎患者标本共27例患者标本培育阳性,阳性率为27.00%;共检出致病菌株27株,其中革兰阳性菌共10株占37.04%,革兰阴性菌8株占29.63%,真菌9株占33.33%;主要革兰阳性菌对万古霉素敏感程度最高,其次为环丙沙星;主要革兰阴性杆菌对亚胺培南的敏感程度最高,其次为舒普深、阿米卡星等;2014-2017年相关性腹膜炎的治疗总有效率较2000-2003年高,导管拔除率较2000-2003年低(P<0.05)。结论应密切留意腹膜炎致病菌的变化,依据致病菌的耐药性,调整药物使用情况,使医治腹膜炎的效果得到进一步提升。OBJECTIVE To study the pathogens of peritoneitis associated with intestinal infection in peritoneal dialysis patients and their drug resistance.METHODS A total of 100 patients with peritoneal dialysis-related peritonitis admitted to our hospital from 2014 to 2017 were enrolled in this study.Isolation and drug resistance test of the pathogens were conducted.The total effective rate,catheter removal and mortality of peritonitis patients from2014 to 2017 and from 2000 to 2003 were recorded and compared.RESULTS A total of 27 cases were positive in the100 cases of peritoneal dialysis-related peritonitis,with a positive rate of 27.00%.There were 10 cases(37.04%)of gram-positive bacteria,8 cases(29.63%)of gram-negative bacteria and 9 cases(33.33%)of fungi.The major gram-positive bacteria were most sensitive to vancomycin,followed by ciprofloxacin.The major gram-negative bacteria were most sensitive to imipenem,followed by Shu Pu Shen(cefoperazone sodium and sulbactam sodium for injection)and amikacin.The total effective rate of the treatment of related peritonitis from 2014-2017 was significantly higher than that of 2000-2003(P<0.05).The rate of catheter removal was significantly decreased(P<0.05).CONCLUSION The clinicians should pay close attention to the changes in peritonitis pathogensand adjust the use of drugs according to the drug resistance of the pathogens,so that the treatment effect of peritonitis can be further improved.

关 键 词：肠道感染 腹膜透析 腹膜炎 致病菌 耐药性 

分 类 号：R572.2[医药卫生—消化系统]