腹膜透析相关腹膜炎患者病原菌分布及抗感染治疗方案评价

Evaluation of distribution of pathogens and anti-infection treatment in the patients with peritoneal dialysis-associated peritonitis

目的分析腹膜透析相关腹膜炎病原菌分布,评价抗感染治疗方案的合理性,促进抗感染治疗合理有效。方法搜集整理医院2015年~2019年收治的130例腹膜透析相关腹膜炎患者的临床资料,根据药敏试验结果分析病原菌的分布情况,从抗菌药物选择、用法用量等方面对抗感染治疗方案进行评价。结果腹膜透析相关腹膜炎病原体主要是细菌及真菌,其中革兰阳性菌47例,革兰阴性菌40例,真菌7例。130例病例中有46例出现抗感染治疗用药不合理现象,主要为经验性抗菌药物选择不合理以及抗菌药物用法用量不合理,不合理率35.38%。结论应结合腹膜透析相关腹膜炎病原菌分布特点及患者具体情况,制定适宜的抗感染治疗方案,促进抗菌药物的合理使用,提高抗感染治疗效果。

Objective To analyse the distribution of pathogenic bacteria in peritoneal dialysis-associated peritonitis and its anti-infective therapy,evaluate the rationality of anti-infective therapy,and improve the effectiveness of anti-infective therapy.Methods We collected the clinical data of 130 patients with peritoneal dialysis-associated peritonitis from 2015 to 2019 in the hospital,to analyse the distribution of main pathogenic bacteria and evaluate the anti-infection therapeutic regimens.Results The major pathogens bacteria of peritoneal dialysis-associated peritonitis were bacteria and fungi;there were 47 cases with gram positive bacterial infections,40 cases with gram negative bacterial infections and 7 cases with fungal infection.46 cases had irrational use of antibacterials,and the unreasonable rate was 35.38%.The Unreasonable phenomena were mainly manifested in the selection and usage of antibacterials.Conclusion It is necessary to make effective anti-infection therapeutic regimens based on the distribution of pathogens of CAPD-related peritonitis and the conditions of the patient to improve rational use of antibacterial drugs and the anti-infection treatment effect.