| ObjectiveThe clinical data of patients with end-stage renal disease coupled with peritoneal dialysis related peritonitis was retrospective analyzed.The clinical characteristics,Pathogenic Bacteria Spectrum and drug resistance rate changes were analyzed and summarized to provide a theoretical basis for clinical prevention and treatment of peritoneal dialysis related peritonitis.Methods324 cases of patients with end-stage renal disease coupled with peritoneal dialysis related peritonitis were chosen.The clinical data of the all cases were analyzed.The outcomes,Pathogenic Bacteria Spectrum and drug resistance rate of the peritonitis group were studied.Results1.There were totally 192 cases of male patients(59.26%)and 132 cases of female patients(40.74%).All patients were over 20 years old.19 cases(5.86%)were between 21 to 30 years old;31 cases(9.57%)were between 31 to 40 years old;74 cases(22.84%)were between 41 to 50 years old;65 cases(20.06%)were between 51 to 60 years old;87 cases(26.85%)were between 61 to 70 years old;41 cases(12.65%)were between 271 to 80 years old;7 cases(2.16%)were between over 80 years old.2.162 cases of patients(50.00%)had peritonitis dialysis ≤ 12 months;54 cases of patients(16.67%)had peritonitis dialysis 13-24 months;41 cases of patients(12.65%)had peritonitis dialysis 25-36 months;14 cases of patients(4.32%)had peritonitis dialysis 37-48 months;53 cases of patients(16.36%)had peritonitis dialysis > 48 months.3.The patient’s clinical symptoms including fever in 62 cases(19.14%);abdominal pain,abdominal distension in 98 cases(30.25%);240 cases of turbid dialysate(74.07%);21 cases of nausea and vomiting(6.48%);5 cases of fatigue,anorexia(1.54%).4.The cause of PD associated peritonitis included: 139 cases of substandard dialysis fluid changing(42.9%);81 cases of intestinal infection(25.00%);5 cases of tunnel infection(1.54%);7 cases of unfree catheter drainage(2.16%);26 cases of incomplete treatment(8.02%);1 case of excessive movement(0.31%);65 cases of unknown reasons(20.06%).5.74 cases of patients had repeated infection: 49 cases had repeated infection 2 times(62.03%);13 cases had repeated infection 3 times(16.46%);6 cases had repeated infection 4 times(7.59%);3 cases had repeated infection 5 times(3.80%);2 cases had repeated infection 6 times(2.53%);1 cases had repeated infection 7 times(1.27%).6.In all 324 cases,228 cases were cured(70.4%);13 cases were recurred(4.0%);9 cases reappeared(2.8%);30 cases relapsed(9.3%);29 cases turned to blood dialysis(9.0%);4 cases reset the tubes(1.2%);11 cases died(3.4%).7.In 324 cases of patients,bacterial positive rate was 53.70%,among which 120 cases were gram positive bacteria(68.97%),45 cases were gram negative bacteria(25.86%),and 9 cases were fungi(5.17%).Vancomycin,linezolid,teicoplanin and tigecycline had the least drug resistance rates to gram positive bacteria,while erythromycin,penicillin G and penicillin had the largest drug resistance rates to gram positive bacteria.Piperacillin / tazobactam,imipenem and ertapenem had the least drug resistance rates to gram negative bacteria,while ampicillin and cefazolin had the largest drug resistance rates to gram negative bacteria.Conclusion1.The distribution characteristics of PD related peritonitis are mainly middle-aged and elderly patients.2.The causes of PD correlated peritonitis included intestinal infection and improper operation.The main clinical symptoms included abdominal pain,abdominal fluid turbidity and fever.Most patients cured after the treatment with antibiotics,and the rest turned to the treatment of hemodialysis.3.The pathogenic bacteria of PD correlated peritonitis included gram positive bacteria(68.97%),gram negative bacteria(25.86%)and fungus(5.17%).The gram positive bacteria is the main pathogenic bacteria.4.The proportion of patients with PD related peritonitis in patients with fungal infection was low.5.The third generation cephalosporins combined with vancomycin should be used for initial therapy for the treatment of PD correlated peritonitis. |
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