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[1]劉美岑 邱付蘭 張 宇 李小林.腹膜透析相關(guān)性腹膜炎臨床調(diào)查分析[J].福建醫(yī)藥雜志,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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腹膜透析相關(guān)性腹膜炎臨床調(diào)查分析()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
42
期數(shù):
2020年04期
頁碼:
140-143
欄目:
調(diào)查報告
出版日期:
2020-08-20

文章信息/Info

Title:
Clinical investigation and analysis of peritioneal dialysis-associated peritionitis
文章編號:
1002-2600(2020)04-0140-04
作者:
劉美岑1 邱付蘭2 張 宇3 李小林4; 5
福建醫(yī)科大學(xué)附屬龍巖第一醫(yī)院(龍巖 364000)
Author(s):
LIU Meicen; QIU Fulan;  ZHANG Yu;  LI Xiaolin.
Longyan First Hospital Affiliated to Fujian edical University,Longyan,Fujian 364000, China
關(guān)鍵詞:
腹膜透析;  腹膜炎;  病原菌;  藥敏試驗;  抗菌藥物
Keywords:
peritoneal dialysis;  peritonitis;  pathogenic bacteria;  drug resistance;  antibiotics
分類號:
R459.5
文獻(xiàn)標(biāo)志碼:
B
摘要:
目的 研究腹膜透析相關(guān)性腹膜炎(PDAP)患者的病原菌分布、藥敏結(jié)果、用藥情況及轉(zhuǎn)歸,為臨床用藥提供依據(jù)。方法 回顧性分析2016年1月至2018年12月在龍巖市第一醫(yī)院行腹膜透析治療時發(fā)生腹膜透析相關(guān)性腹膜炎的165例患者的腹透液病原菌、藥敏結(jié)果、用藥情況及轉(zhuǎn)歸。結(jié)果 我院PDAP的病原菌主要為革蘭陽性菌,占45.45%。革蘭陽性菌中,金黃色葡萄球菌和凝固酶陰性葡萄球菌對苯唑西林的耐藥率分別為68.75%、69.57%,對萬古霉素的耐藥率均為0。革蘭陰性菌中,大腸埃希菌對頭孢曲松、頭孢噻肟和頭孢他啶的耐藥率分別為33.33%、33.33%和14.29%,對阿米卡星的耐藥率為0.00%; 肺炎克雷伯氏菌對頭孢噻肟和阿米卡星的耐藥率為0。留腹抗感染治療總有效率為84.85%。我院大部分患者留腹治療療程在2～3周。結(jié)論 我院PDAP的病原菌主要為革蘭陽性菌。針對葡萄球菌屬引起的PDAP,因我院耐甲氧西林葡萄球菌檢出率高,一代頭孢不推薦使用,可選用糖肽類抗菌藥物如萬古霉素作為該類菌屬的經(jīng)驗用藥。革蘭陰性菌中,可經(jīng)驗性選用氨基糖苷類治療腸桿菌屬引起的PDAP。留腹給藥為我院治療PDAP的首選途徑。針對腹膜透析相關(guān)性腹膜炎的治療療程,建議2～3周的留腹抗生素治療。
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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備注/Memo

備注/Memo:
1 藥劑科臨床藥學(xué)室; 2 微生物室; 3 腎內(nèi)科; 4 腎內(nèi)科; 5 通信作者
更新日期/Last Update: 2020-08-20