【摘要】 目的:分析阳江地区腹膜透析相关性腹膜炎(PDAP)的病原菌及耐药性,为腹膜炎的预防和治疗提供依据。方法:选取2018年8月-2020年4月本院肾内科收治的201例腹膜透析患者。按照是否发生PDAP的情况分为腹膜炎组90例与非腹膜炎组111例。分析腹膜炎的病原菌及耐药性情况。结果:两组血红蛋白、血葡萄糖、血肌酐、血清钙、血清镁、血清铁比较,差异均无统计学意义(P>0.05);腹膜炎组血清白蛋白水平、血清磷均低于非腹膜炎组,差异均有统计学意义(P<0.05)。腹膜炎组90例患者,透出液病原菌培养阳性90例,其中混合感染2例,共检出菌株94株,其中革兰阳性菌65株(69.15%),革兰阴性菌28株(29.79%),真菌1株(1.06%)。革兰阳性菌对青霉素G的耐药性最高,对替加环素、利奈唑胺、万古霉素、利福平的耐药率最低;革兰阴性菌对头孢唑林耐药性最高,对厄他培南、头孢哌酮舒巴坦、阿米卡星的耐药率最低。结论:本病的病原菌主要以革兰阳性菌为主,革兰阳性菌对青霉素G的耐药性高,对替加环素、利奈唑胺、万古霉素、利福平基本不耐药;革兰阴性菌感染的患者建议应用厄他培南、头孢哌酮舒巴坦、阿米卡星进行治疗。更多还原

【Abstract】 Objective:To analyze the pathogens and drug resistance of peritoneal dialysis associated peritonitis (PDAP) in Yangjiang area,so as to provide basis for the prevention and treatment of peritonitis.Method:A total of 201 peritoneal dialysis patients admitted to the department of nephrology of our hospital from August 2018 to April 2020 were selected.The patients were divided into the peritonitis group (n=90) and the non-peritonitis group (n=111) according to the occurrence of PDAP.The pathogenic bacteria and drug resistance of peritonitis were analyzed.Result:There were no significant differences in hemoglobin,blood glucose,serum creatinine,serum calcium,serum magnesium and serum iron between two groups (P>0.05).The levels of serum albumin and serum phosphorus in the peritonitis group were lower than those in the non-peritonitis group,with statistical significance (P<0.05).Of 90 patients in the peritonitis group,90 cases were positive for pathogenic bacteria culture in the efflux,including 2 cases of mixed infection.A total of 94 strains were detected,including 65 strains (69.15%) of Gram-positive bacteria,28 strains (29.79%) of Gram-negative bacteria,and 1 strain (1.06%) of fungus.Gram-positive bacteria had the highest drug resistance to Penicillin G,and the lowest drug resistance rate to Ticacycline,Linezolid,Vancomycin and Rifampicin.Gram-negative bacteria had the highest resistance to Cefazolin,and the lowest resistance rate to Ertapenem,Cefoperazone and Sulbactam and Amikacin.Result:The pathogens of this disease are mainly Gram-positive bacteria,Gram-positive bacteria has high resistance to Penicillin G,and are basically resistant to Tigecycline,Linezolid,Vancomycin and Rifampicin.Patients with Gram-negative bacterial infection are recommended for treatment with Ertapenem,Cefoperazone and Sulbactam,and Amikacin.更多还原