Abstract: Objective: To investigate the characteristics of the gut microbiota in refractory peritoneal dialysis⁃associated peritonitis (PDAP) and provide preliminary evidence for targeting the gut microbiota in its prevention and treatment. Methodology: Fecal specimens were collected from PD patients in the Department of Nephrology, Zhujiang Hospital of Southern Medical University, between January and October 2021. Participants were divided into a refractory PDAP group (n=24) and a control PD group (n=20). 16S rDNA sequencing was employed to analyze differences in species diversity and composition. Results: The flora composition of the refractory PDAP group at the phylum level mainly included Firmicutes (32.5%), Bacteroidetes (27.8%), Proteobacteria (23.2%), and Actinobacteria (13.2%). There were no significant differences in α diversity (P>0.05), but significant differences in β diversity (P=0.008) between the two groups. The refractory PDAP group had more uremic toxin⁃producing gut microbiota (e.g., Corynebacterium, Enterococcus, Pseudomonas, Staphylococcus) and fewer short⁃chain fatty acid⁃producing gut microbiota (e.g., Prevotella, Dialister, Peptococcus, Weissella). Conclusion: Refractory PDAP patients have more uremic toxin⁃producing gut microbiota and fewer short⁃chain fatty acid⁃producing gut microbiota.

Key words: peritoneal dialysis associated peritonitis, intestinal flora