腹膜透析相关性腹膜炎患者易感病原菌及耐药性分析

Frequent Species and resistance of pathogens causing infections in Patients with peritoneal dialysis related peritonitis in our hospital from 2013 to 2014

目的探讨腹膜透析相关性腹膜炎(PDAP)患者的致病菌分布和药敏特点,为临床合理利用抗菌药物提供依据。方法采取回顾性方法分析2013年1月-2014年12月就诊的PDAP患者的致病菌分布及耐药性。结果423例PDAP患者,其中195例培养阳性,培养阳性率为46.1%,共检出致病菌198株。其中革兰阳性菌119株(60.1%),革兰阴性菌中肠杆菌属35株(17.7%),真菌40株(20.2%)。葡萄球菌属对的耐药率替考拉宁最低,为3.3%;对青霉素耐药率最高为96.7%。肠杆菌属对阿米卡星和美罗培南均有较高敏感性。结论 PDAD的致病菌以革兰阳性菌为主,且对临床抗菌药物呈现出不同的耐药性。在经验用药基础上,应依据病原菌培养、药敏结果,选择治疗PDAP的合适抗生素。

Objective To investigate the distribution and drug resistance of pathogenic bacteria of peritonitis in peri- toneal dialysis-associated peritonitis （PDAP） ,in order to provide basis for the reasonable use of antibiotics. Methods Perito- neal dialysis-related peritonitis, who were treated in the hospital from Jan 2013 to Dec 2014 ,were collected in the study, then the distribution and drug resistance of the pathogens were retrospectively analyzed. Results （ 1 ） Among 423 cases of PDAP patients with peritonitis, 195 cases were tested positive for pathogenic bacteria, with positive rate of 46.1%. There were culti- vated 198 strains,including Gram-positive bacteria （ 119 strains, 60. 1% ）, Gram-negative bacteria （35 strains, 17.7% ） and fungus （40 strains,20.2% ）. （2） Staphylococcus showed lowest resistance to Teicoplanin （3.3%）, and highest resistance to Penicillin （96.7%）. （3） Enterobacter kept good sensitivity to Amikacin and Meropenemforlnjection. Conclusion Gram-pos- itive bacteria are the most common pathogens of peritonitis in patients undergoing PDAP, and shows different degree of resist- ance to common clinical antibiotics. In the empirical treatment, we should be on the basis of the pathogenic bacteria culture and drug susceptibility results, effective treatment for peritoneal dialysis related peritonitis sensitive antibiotics.