隧道口应用莫匹罗星乳膏结合口腔清洁对腹膜透析患者腹膜炎感染的影响

发布时间：2018-02-25 15:12

本文关键词： 腹膜透析腹膜炎感染莫匹罗星药敏　出处：《中华医院感染学杂志》2017年13期 　论文类型：期刊论文

【摘要】：目的探讨隧道口应用莫匹罗星乳膏结合口腔清洁对腹膜透析患者腹膜透析相关性腹膜炎感染的影响。方法选取医院2012年1月-2015年12月收治的腹膜透析患者160例为研究对象;采用随机数字表法将160例患者随机分为观察组和对照组,每组80例;对照组采用常规对症治疗和预防性措施,观察组患者在对照组基础上,每天隧道口换药后在腹透管出口处外涂莫匹罗星乳膏,同时要求患者每天刷牙3次,换药操作时戴口罩;门诊随访1年,记录两组隧道口炎、腹膜炎感染的发生率和腹膜炎感染住院治疗时间;感染隧道炎留取脓性分泌物培养+药敏试验,感染腹膜炎后留取留腹4小时以上透析后透出液行常规检查和腹透液培养,并做药敏试验。结果观察组隧道口炎、腹膜透析相关性腹膜炎感染发生率和腹膜透析相关性腹膜炎感染住院时间均显著低于对照组(P0.05);在36例腹膜炎感染患者中,透出液培养阳性者32例,阳性率为88.89%;共培养出病原菌35株,其中3例患者培养出两种致病菌;35株病原菌中革兰阳性菌19株,占54.29%,革兰阴性菌16株,占45.71%;革兰阳性菌对莫匹罗星、万古霉素、利奈唑胺和替考拉宁耐药率较低,分别为0、5.26%、5.26%和0;革兰阴性菌对莫匹罗星、阿米卡星和头孢哌酮/舒巴坦的耐药率较低,分别为6.25%、6.25%和6.25%。结论隧道口使用莫匹罗星乳膏联合定期口腔清洁,有助于降低腹膜透析患者相关腹膜炎感染的发生,莫匹罗星乳膏可作为腹膜炎感染预防的首选药物。
[Abstract]:Objective to investigate the effect of mupiroxine cream combined with oral cleaning on peritoneal dialysis associated peritonitis infection in patients with peritoneal dialysis. 160 patients were randomly divided into observation group (n = 80) and control group (n = 80). After dressing change at the entrance of the tunnel every day, the patients were required to brush their teeth three times a day and wear a mask at the exit of the peritoneal dialysate, and the two groups were followed up for one year, and the two groups were recorded. The incidence of peritonitis infection and the duration of hospitalization for peritonitis infection, the drug sensitivity test for the culture of purulent secretions left in the infected peritonitis, the release of peritoneal fluid after dialysis for more than 4 hours after the infection of peritonitis, the routine examination and the culture of peritoneal dialysate, Results the incidence rate of peritonitis, peritoneal dialysis associated peritonitis and the hospitalization time of peritoneal dialysis associated peritonitis in the observation group were significantly lower than those in the control group (P 0.05), and in 36 patients with peritonitis infection, the incidence of peritonitis in the observation group was significantly lower than that in the control group (P 0.05). Of the 35 strains of pathogenic bacteria, 19 were Gram-positive bacteria (54.29%), 16 were Gram-negative bacteria (45.71%), and the other 35 strains were Gram-positive bacteria against mopidoxin. The resistance rates of vancomycin, linazolamine and teicoplanin were 0.5.26% and 0.0.The resistance rates of Gram-negative bacteria to mupirosin, amikacin and cefoperazone / sulbactam were lower. Conclusion the combination of mupiroxine cream and regular oral cleaning at the tunnel entrance is helpful to reduce the incidence of peritonitis infection in peritoneal dialysis patients. Mupirosin cream can be used as the first choice for the prevention of peritonitis infection.
【作者单位】：海南省人民医院肾病风湿科;
【分类号】：R572.2;R692.5

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