Analysis Of Antibiotic Resistance To Pathogenic Bacteria And Risk Factors Of Peritoneal Dialysis Related Peritonitis

Objective To study the pathogenic bacteria and their resistance inperitoneal dialysis patients with peritonitis,investigate the risk factors of peritoneal dialysisrelated peritonitis.Methods In this retrospective study,medical records of 38 peritoneal dialysis patients with peritonitis and 33 patients without peritonitis as control were reviewed in our hospital.The factors of peritonitis including age,sex,hemoglobin,albumin,ureanitrogen,creatinine, diabetes,serum potassium,calcium,phosphorus,parathyroid hormone were analyzed. The pathogenic bacteria and their antibiotic resistance in patients with peritonitis were studied.Results Among 66 cases with peritonitis,33 cases cultured positive(50%),In total,35 strains were cultured,including 20 Gram-positive strains(54.14%),11 Gram-negative strains(31.43%)and 4 fungi(11.43%)in patients with peritonitis.The most common pathogens were coagulase-negative staphylococcus(45%).2 cases with polyinfection(6.06%) were found.one case isolated mixed Gram-positive and Gram-negative organisms,another one was mixed Gram-negative and fungi organisms.The antibiotic resistance test of the Gram-positive bacteria appeared that antibiotics with the lowest resistance were vancomycin(0),linezolid(0),teicoplanin(0),tigecycline(0),macrodantin(0),and the highest were penicillin(68.42%),azothromycin(57.14%),erythrocin(42.11%),cefazolin(30%). theantibiotic resistance test of the Gram-negativebacteria showed that antibiotics with the highest resistance were penbritin(87.50%),cefotaxime(30%),amoxycillin/clavulanate(25%),and the lowest were ceftazidime(0), ciprofloxacin(0), cefepime(0), levofloxacin(0), piperacillin/heazoletemple(0),amikacin(9.09%),imipenem(9.09%),meropenem(9.09%).The antibiotic susceptibility rate of fungi to fluconazole(0), fluorine cytosine(0), amphotericin B(0) were lowest.Logistic regression suggested that lower albumin level(albumin ? 30 g/L) was the risk factor of peritoneal dialysis related peritonitis.Conclusion Gram-positive cocci were the most common pathogenic bacteria leading to peritoneal dialysisrelated peritonitis. According to the antibiotic resistance test,vancomycin,linezolid,teicoplanin,tigecycline and macrodantin can be the effective medicine to Gram-positive cocci. Ceftazidime, ciprofloxacin, cefepime, levofloxacin, piperacillin/heazole temple, amikacin, imipenem and meropenem can be the effective medicine to Gram-negative bacilli. Cefazolin plus amikacin maybe an effective medicine on initial treatment of peritoneal dialysis related peritonitis.Lower albumin level(albumin ? 30 g/L) was the risk factor of peritoneal dialysis related peritonitis.