54例次腹透相关腹膜炎病原菌药敏结果分析

发布时间：2018-12-06 21:59

【摘要】：目的:分析腹透相关腹膜炎的病原菌分布,耐药性情况,为抗菌药物的合理使用提供依据。方法:回顾性分析2012年1月-2015年6月入住医院的腹透相关腹膜炎54例次,统计病原菌分布、敏感性情况及转归情况。结果:(1)54例次病原菌培养阳性38例次(70.4%),其中革兰阳性菌27例次(71%),以葡萄球菌和链球菌居多;革兰阴性菌10例次(26.3%),以大肠埃希菌最多;真菌1例次(2.6%)。(2)革兰阳性(G+)菌对复方磺胺、环丙沙星、克林霉素、糖肽类敏感率分别是71.4%,74.1%,80%,100%;革兰阴性(G-)菌对环丙沙星、头孢他啶、阿米卡星、头孢哌酮舒巴坦、哌拉西林他唑巴坦、亚胺培南敏感率分别是72.7%,81.8%,81.8%,90.9%,90.9%,100%。(3)腹膜炎总体治愈率87%,G+菌治愈率(96.3%)高于革兰阴性菌治愈率(80%)。(4)重现、复发性腹膜炎病原菌敏感性均出现下降。结论:腹透相关腹膜炎病原菌以G+菌为主,经验治疗可选三代头孢联合万古霉素。最终仍要根据药敏结果及时调整用药。
[Abstract]:Objective: to analyze the distribution of pathogens and drug resistance of peritoneal dialysis associated peritonitis and to provide evidence for rational use of antimicrobial agents. Methods: 54 cases of peritoneal dialysis associated peritonitis admitted to hospital from January 2012 to June 2015 were analyzed retrospectively. Results: (1) 38 cases (70.4%) were positive for 54 times of pathogen culture, 27 cases (71%) were Gram-positive bacteria, most were Staphylococcus and Streptococcus, 10 cases (26.3%) were Gram-negative bacteria, the most was Escherichia coli. The sensitivity of gram positive (G) bacteria to compound sulfa, ciprofloxacin, clindamycin and glycopeptide in 1 case (2.6%). (2) was 71.4% and 74.1%, respectively. The sensitivity rate of Gram-positive (G) bacteria to compound sulfamethamide, ciprofloxacin, clindamycin and glycopeptide was 71.4% and 74.1% respectively. The sensitivity rates of gram-negative bacteria to ciprofloxacin, ceftazidime, amikacin, cefoperazone sulbactam, piperacillin tazobactam and imipenem were 72.7%, 81.8% and 81.8%, respectively. (3) the overall cure rate of peritonitis was 87.3%, and the cure rate of Gram-negative bacteria (80%). (_ 4) was higher than that of Gram-negative bacteria (96. 3%), and the susceptibility of pathogenic bacteria to recurrent peritonitis was decreased. Conclusion: G bacteria is the main pathogen of peritoneal dialysis associated peritonitis, and three generations of cephalosporins combined with vancomycin can be treated empirically. Finally, the drug should be adjusted according to the results of drug sensitivity.
【作者单位】：苏州大学附属第一医院药学部;南京医科大学第一附属医院药学部;南京医科大学附属南京儿童医院药学部;苏州大学附属第一医院肾内科;苏州大学附属第一医院检验科;
【分类号】：R446.5;R459.5

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