腹膜透析腹膜炎致病菌的耐药性分析

Pathogens and Their Resistance in CAPD-related Peritonitis

目的 探讨持续性非卧床腹膜透析 (CAPD)腹膜炎的致病菌及其耐药性。方法 回顾性分析 117例CAPD腹膜炎的致病菌及其耐药性。结果 31例培养阳性 ,透出液培养阳性率为 2 6 .5 % ,其中革兰阳性球菌 11例 ,革兰阴性杆菌 9例 ,真菌 11例。所有革兰阳性球菌对万古霉素敏感 ,大部分 (85 .7% )对环丙沙星敏感 ;革兰阴性杆菌主要对阿米卡星 (71.4 % )、舒普深 (83.3% )、亚胺培南 (10 0 % )敏感 ,庆大霉素耐药率为 4 4 .4 %。结论 革兰阴性杆菌比例有所增加 ,革兰阳性球菌大部分对环丙沙星敏感 ,革兰阴性杆菌大部分对阿米卡星、舒普深、亚胺培南敏感 ,对传统使用的庆大霉素耐药率较高。

OBJECTIVE To investigate the pathogens and their resistance in CAPD related peritonitis. METHODS Pathogens and their resistance in 117 cases of CAPD related peritonitis were analyzed retrospectively. RESULTS Thirty one cases were culture positive with a positive rate of 26.5%, including 11 cases with Gram positive cocci, 9 cases with Gram negative bacilli and 11 cases with fungi. Their drug sensitivity was 85.7% of the Gram positive cocci sensitive to ciprofloxacin and all sensitive to vancomycin; 71.4% of bacilli sensitive to amikacin; 83.3% sensitive to cefoperazone/sulbactam (Sulperazone) and 100% sensitive to imipenem and 44% of bacilli resistant to gentamicin. CONCLUSIONS There is increasing proportion of peritonitis caused by Gram negative bacilli. Most of Gram positive cocci were sensitive to ciprofloxacin, and most of Gram negative bacilli were sensitive to amikacin, Sulperazone and imipenem. The resistant rate to gentamicin is increasing.