腹膜透析相关性链球菌腹膜炎临床分析

Clinical analysis of peritoneal dialysis-associated Streptococcal peritonitis

目的探讨腹膜透析相关性链球菌腹膜炎的实验室检查特征,包括透析液常规、血常规.透析液细菌培养与药敏试验,为临床医生提供诊疗依据。方法选取本院2015年1月--2020年12月发生的链球菌腹膜炎的持续性不卧床腹膜透析(CAPD)患者作为研究对象,选取同时期腹膜透析非腹膜炎患者作为阴性对照,回顾性分析链球菌腹膜炎患者的透析液常规、血常规、hs-CRP、PCT及细菌耐药性。结果共发生409例腹膜透析相关性腹膜炎,共培养出73株链球菌,占17.85%。腹膜炎组透析液白细胞计数、外周血白细胞计数、hs-CRP、PCT均明显高于非腹膜炎对照组(P<0.05)。73株链球菌对红霉素、四环素敏感性较差。结论腹膜透析相关性腹膜炎患者的链球菌检出率较高,临床医生应重视实验室检查结果,在临床治疗过程中重视合理用药,避免耐药菌的产生或耐药性加剧。

Objective To explore the laboratory characteristics of peritoneal dialysis-associated Streptococcus peritonitis,including routine dialysate,blood routine,bacterial culture of dialysate and drug sensitivity test,so as to provide clinical doctors with the basis for diagnosis and treatment.Methods Continuous ambulate peritoneal dialysis(CAPD)patients with Streptococcal peritonitis from January 2015 to December 2020 in our hospital were selected as the research objects,and non-peritonitis patients on peritoneal dialysis at the same period were selected as negative control.Dialysate routine,blood routine,hs-CRP,PCT and bacterial resistance of Streptococcal peritonitis patients were retrospectively analyzed.Results A total of 409 cases of peritoneal dialysis-associated peritonitis occurred,and 73 streptococcus strains were cultured,accounting for 17.85%.The WBC count of dialysate,WBC count of peripheral blood,hs-CRP and PCT in peritonitis group were significantly higher than those in non-peritonitis control group(P<0.05).73 strains of streptococcus were less sensitive to erythromycin and tetracycline.Conclusion The detection rate of streptococcus in patients with peritoneal dialysis associated peritonitis was high.Clinicians should pay attention to laboratory examination results and rational drug use during clinical treatment,so as to avoid the generation of drug-resistant bacteria or the increase of drug resistance.