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[接受自动持续循环腹膜透析的儿童腹膜炎及导管出口处感染的发生率]

[Incidence of peritonitis and catheter exit site infection in children undergoing automatic continuous cyclic peritoneal dialysis].

作者信息

Baciulis Vytautas, Jankauskiene Augustina, Cerkauskiene Rimante

机构信息

Children's Clinic, Vilnius University, Vilnius, Lithuania.

出版信息

Medicina (Kaunas). 2003;39 Suppl 1:70-4.

Abstract

The aim of this study was to find out the clinical aspects of peritonitis and catheter exit site infection in children undergoing continuous cyclic peritoneal dialysis. The incidence of peritonitis and catheter related infections were reviewed in 8 children on continuous cyclic peritoneal dialysis over a mean period of 14.9+/-15.8 months. Peritonitis occurred in 4 children. There were 14 episodes of peritonitis. The mean time from starting dialysis to the first episode of peritonitis was 1.9+/-1.0 months. The incidence of peritonitis was 1 episode in 9 treatment months. Gram-negative organisms (Enterococcus spp.) were responsible for the majority of episodes (35.7%) of peritonitis and gram-positive bacteria mainly caused the catheter exit site infections (Staphylococcus epidermidis). The incidence of catheter exit site infection was one episode in 8 treatment months. Recurrent peritonitis was present in 1 case. Most patients with dialysis-related peritonitis and catheter exit site infection responded to antibiotic therapy. Catheter was replaced in 2 patients. The mortality rate was 2 out of 8 patients but none of the deaths were related to peritonitis. Patients with exit site infection had 7 times higher risk than those without developing peritonitis.

摘要

本研究的目的是了解接受持续性循环腹膜透析的儿童腹膜炎及导管出口处感染的临床情况。对8例接受持续性循环腹膜透析的儿童进行了回顾性研究,平均随访时间为14.9±15.8个月,观察腹膜炎及导管相关感染的发生率。4例儿童发生腹膜炎,共出现14次腹膜炎发作。从开始透析到首次发生腹膜炎的平均时间为1.9±1.0个月。腹膜炎的发生率为每9个治疗月1次发作。革兰阴性菌(肠球菌属)是大多数腹膜炎发作(35.7%)的致病菌,而革兰阳性菌主要导致导管出口处感染(表皮葡萄球菌)。导管出口处感染的发生率为每8个治疗月1次发作。1例患者出现复发性腹膜炎。大多数与透析相关的腹膜炎和导管出口处感染患者对抗生素治疗有反应。2例患者更换了导管。8例患者中有2例死亡,但均与腹膜炎无关。发生出口处感染的患者发生腹膜炎的风险比未发生者高7倍。

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