Domoto D T, Weindel M E, Blalock S, Ballal H S
Department of Internal Medicine, St. Louis University School of Medicine, Missouri.
Adv Perit Dial. 1991;7:173-5.
The efficacy of streptokinase to lyse biofilm in the catheters of CAPD patients with peritonitis was examined in a retrospective review of 10 infusions in 9 patients with difficult to resolve peritonitis. 750,000 units of streptokinase were used. This helped resolve peritonitis in 8 of 10 uses, including two cases due to gram negative bacteria. Staphylococcus was cultured in the other 8 cases. The two episodes which failed to respond were due to Staph epidermidis relapsing peritonitis and required either catheter removal or two additional courses of antibiotics before peritonitis resolved. One infusion was complicated by severe hypotension which was thought to be due to generalized sepsis. The patient had received a previous streptokinase infusion but skin tests for IgE allergy to streptokinase were negative. We conclude that streptokinase is efficacious in the resolution of slow to resolve peritonitis due to either gram positive or gram negative organisms, and potentially saved seven patients from catheter removal.
通过对9例难治性腹膜炎患者的10次链激酶输注进行回顾性分析，研究了链激酶溶解持续性非卧床腹膜透析（CAPD）腹膜炎患者导管生物膜的疗效。使用了75万单位的链激酶。这使得10次使用中有8次腹膜炎得到缓解，其中包括2例由革兰氏阴性菌引起的病例。另外8例培养出葡萄球菌。未产生反应的2例是由于表皮葡萄球菌复发性腹膜炎，在腹膜炎缓解之前需要拔除导管或额外使用两个疗程的抗生素。1次输注出现严重低血压并发症，认为是由全身性败血症所致。该患者此前曾接受链激酶输注，但对链激酶IgE过敏的皮肤试验为阴性。我们得出结论，链激酶对革兰氏阳性或革兰氏阴性菌引起的难治性腹膜炎有效，并且可能使7例患者免于拔除导管。
