关键词: 腹膜透析, 腹膜炎, 病原菌, 耐药性

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To analysis the pathogen spectrum and resistance to common antibiotics in peritoneal dialysisassociated peritonitis (PDAP).
Ｍｅｔｈｏｄｏｌｏｇｙ：One thousand four hundred thirty two  peritoneal dialysis patients in Department of Nephrology of Southern Hospital between January 2015 and December 2017,were retrospectively analyzed.The pathogenic bacteria spectrum and drug resistance of 203 PDAP cases were analyzed.
Ｒｅｓｕｌｔｓ：A total of 171 patients with 203 episodes of PDAP were included in this study,and 159 cases (7833%) had a positive bacterial culture from peritoneal dialysate fluid,including single bacterial infections (n=150),fungal infections (n=5),and multiple infections (n=4).A total of 47 kinds of pathogens were identified,including 19 (4043%) grampositive cocci strains (the most common was Staphylococcus spp),15 (3191%) gramnegative bacilli strains (the most common was Escherichia coli),4 (851%) fungal strains,and 9 (1915%) others.The drug sensitivity test showed that the grampositive cocci were sensitive to vancomycin(9487%),but they had the highest resistance to penicillin (75%).They were also resistant to clindamycin(7143%) and cefazolin(6765% ) respectively.The gramnegative bacilli were sensitive to imipenem(9615%),but they had a higher resistance to ceftriaxone(6000%),and a lower resistance to piperacillin(5789%) and cefotaxime(5000% ).The voriconazole,and itraconazole were sensitive in fungal infections.One hundred sixtytwo  of the 203 patients (7980%) responded to antibiotic treatment,37 cases did not respond to conservative treatment and were converted to hemodialysis after Tenckhoff catheter removal (1822%),and 4 cases (197%) died.
Ｃｏｎｃｌｕｓｉｏｎ：PDAP is a common complication of peritoneal dialysis.Regular analysis of pathogenic bacteria distribution and drug resistance can effectively adjust the existing empirical treatment programs and improve the cure rate.

Key words: peritoneal dialysis, infectious peritonitis, pathogens, drug resistance