腹膜透析相关肠源性腹膜炎38例的病原菌及药敏分析

An analysis on pathogenic bacteria and antibiotic sensitivity in 38 patients with peritoneal dialysis-related enterogenous peritonitis

目的分析38例(43例次)腹膜透析相关肠源性腹膜炎的病原菌及药敏。方法回顾性分析43例次肠源性腹膜炎患者的临床资料。结果病原菌为革兰阴性杆菌38例次,肠球菌6例次,两种菌混合感染5例次。最常见病原菌为革兰阴性杆菌,以大肠杆菌及肺炎克雷伯杆菌为主。革兰阴性杆菌对头孢哌酮舒巴坦、亚胺培南及美罗培南敏感。肠球菌对氨苄西林、万古霉素、替考拉宁和利奈唑胺敏感。因肠源性腹膜炎而致拔管1例、转血液透析1例、死亡4例,病原菌均为革兰阴性杆菌。肠球菌致病患者均得到完全缓解。结论腹膜透析患者肠源性腹膜炎最常见病原菌为革兰阴性菌,应选择敏感药物治疗。

Objective To analyze the pathogenic bacteria and antibiotic sensitivity in 38 patients（43 case-times）with peritoneal dialysis-related enterogenous peritonitis.Methods Data of in 38 patients with enterogenous peritonitis underwent peritoneal dialysis were retrospectively analyzed.Results Pathogenic bacteria were Gram-negative bacillus in 38 case-times,Enterococcus in 6 casetimes,and two kinds of bacteria mixed infection in 5case-times.Gram-negative bacilli were the most common pathogenic bacteria,which were mainly Escherichia coli and Klebsiella pneumoniae.Gramnegative bacilli were sensitive to cefoperazone sulbactam,imipenem and meropenem.Enterococcus was sensitive to ampicillin,vancomycin,teicoplanin and linezolid.Of six cases infected by Gram-negative bacillus,one case underwent catheter removal,one case received hemodialysis instead of peritoneal dialysis,and four cases died.The patients infected by Enterococcus were all completely remissioned after treatment.Conclusion Gram-negative bacilli are the most common pathogenic bacteria in the patients with peritoneal dialysis-related enterogenous peritonitis.The sensitive drugs should be selected in the treatment.