长效抗菌材料预防腹膜透析导管相关性感染的临床研究  

Clinical study on the efficacy of long-acting antibacterial materials in preventing catheterrelated infection in peritoneal dialysis

作　　者：于云霞[1] 王鹏飞[2] 曹颖[1] 赵云珠 左兰 杨明莹[3] YU Yun-xia;WANG Peng-fei;CAO Ying;ZHAO Yun-zhu;ZUO Lan;YANG Ming-ying(Department of Nephrology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101;Center Laboratory, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101)

机构地区：[1]昆明医科大学第二附属医院肾内科,云南昆明650101 [2]昆明医科大学第二附属医院中心试验室,云南昆明650101 [3]昆明医科大学第二附属医院护理部,云南昆明650101

出　　处：《皮肤病与性病》2019年第3期334-339,共6页Dermatology and Venereology

基　　金：云南省卫生内设研究机构(2016NS258)

摘　　要：目的 研究长效抗菌材料对腹膜透析导管皮肤出口处细菌繁殖和抑制效果。方法 对进行腹膜透析的20例患者,应用长效抗菌材料和蒸馏水对照处理导管皮肤出口处,观察细菌繁殖和抑制效果。结果 16srRNA扩增灰度分析表明4h时间点实验组相比对照组的皮肤表面核酸水平更低,二代高通量测序分析16srRNA扩增子表明所有患者皮肤样本组成丰度最高的为鞘脂单胞菌目(Sphingomonadales)下的多种鞘氨醇单胞菌。组间物种丰度差异性分析显示2h时间点对照组在丰度较高的物种上比实验组丰度更高,而4h时间点,对照组相较于试验组存在更多的物种丰度,且贡献差异性的主要为稀有OUT的种类水平。结论 使用长效抗菌材料在防治腹膜透析导管相关性感染在长效时间点(2h和4h)具有细菌抑制效果。Objective To study the effect of long-acting antibacterial materials on bacterial reproduction and inhibition at the outlet of peritoneal dialysis catheter skin. Methods Twenty patients undergoing peritoneal dialysis were treated with long-acting antibacterial materials and distilled water to observe the bacterial growth and inhibition at the skin exit of the catheter by using self‐controlled study. Results The 16 s rRNA amplification gradation analysis showed that the skin surface nucleic acid level of the experimental group was lower than that of the control group at the 4 h time point. The second-generation high-throughout sequencing analysis of the 16 s rRNA amplicon showed that a variety of Sphingomonas species under Sphingomonadales was the highest of the skin abundance in all patients. The analysis of species abundance between groups showed that the control group was higher in the higher abundance species than the experimental group at the 2 h time point, while at the 4 h time point, the control group had more species than the experimental group, mainly in the level of rare OUT. Conclusion Using long-acting antibacterial materials in the prevention and treatment of peritoneal dialysis catheter-related infections has a bacterial inhibitory effect at long-term time points(2 h and 4 h).

关 键 词：腹膜透析 出口处细菌 长效抗菌材料 

分 类 号：R459.5[医药卫生—治疗学] R197.323.4[医药卫生—临床医学]