152例次腹膜透析相关性腹膜炎的细菌谱及耐药性分析

Analysis of bacterial spectrum and drug resistance of 152 cases of peritoneal dialysis-associated peritonitis

目的探讨腹膜透析相关性腹膜炎(PDAP)患者的致病菌及耐药性。方法回顾性分析郑州大学第一附属医院肾内科腹膜透析中心2014年1月至2017年12月收治的152例次PDAP患者的致病菌及耐药性结果。结果在152例次PDAP患者中,病原菌培养阳性率为67.76%(103/152)。革兰阳性(G+)菌60例次(58.25%,60/103),革兰阴性(G-)菌32例次(31.07%,32/103),真菌11例次(10.68%,11/103)。革兰阳性菌对青霉素G耐药率最高,革兰阴性菌对氨苄西林、头孢唑啉均有较高耐药率。结论革兰阳性菌仍是腹膜透析相关性腹膜炎的主要致病菌。可选用万古霉素和厄他培南/亚胺培南作为PDAP的经验用药。

Objective To investigate the microbial spectrum and antibiotic resistance of peritoneal dialysis associated peritonitis(PDAP).Methods A retrospective analysis was made of 152 patients with PDAP in the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2017.Distribution of pathogenic bacteria and its resistance to common antibiotics were analyzed.Results Among the 152 cases of PDAP,the positive rate of pathogen culture was 67.76%(103/152),including 60 cases(58.25%,60/103)of gram-positive bacteria,32 cases(31.07%,32/103)of gram-negative bacilli,and 11 cases(10.68%,11/103)of fungi.Drug sensitivity test results showed that gram-positive bacteria showed a high resistance rate to Penicillin G.Gram-negative bacilli were resistant to Ampicillin and cefazolin with a high rate.Conclusions The main pathogen of PDAP is gram-positive bacteria.Vancomycin and ertapenem/imipenem can be used as empirical drugs for PDAP.