Kabat-Koperska Joanna, Gołembiewska Edyta, Ciechanowski Kazimierz
Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.
Pol Arch Med Wewn. 2008 Dec;118(12):694-9.
Peritoneal dialysis-related peritonitis (PDRP) is the most common complication of dialysis in patients undergoing continuous ambulatory peritoneal dialysis.
The study analyzes incidence of PDRP, pathogens responsible for the disease and response to treatment in patients at the Peritoneal Dialysis Clinic of the Department of Nephrology, Transplantology and Internal Medicine of Pomeranian Medical University and the Independent Public University Hospital No 2 in Szczecin in the years 2005-2007.
Within 36 months, 20 peritonitis incidents have been diagnosed in 18 subjects of 89 patients undergoing peritoneal dialysis.
The incidence of PDRP was 1 episode/32 patient-months with 45% of PDRP episodes caused by Gram-positive bacteria, 40% by Gram-negative bacteria, and 5% by fungi. Staphylococcus aureus was the most common pathogen among Gram-positive bacteria and so were equally Klebsiella oxytoca and Enterobacter cloacae among Gram-negative bacteria. A satisfactory percentage of successful standard therapy (80%) was achieved; in 20% of PDRP cases removal of the Tenckhoff catheter was necessary.
A higher proportion of PDRP caused by Gram-negative bacteria has been observed as compared to the data from other centers. There was high susceptibility of the isolated strains to third-generation cephalosporins and chinolones. Low incidence of PDRP in the center and bacteriological profile of strains causing the disease confirm high qualifications and training quality of the patients and the correct insertion of dialysis catheters.
腹膜透析相关腹膜炎(PDRP)是持续性非卧床腹膜透析患者最常见的透析并发症。
本研究分析了2005 - 2007年期间,在波美拉尼亚医科大学肾脏病、移植与内科系腹膜透析门诊以及什切青市第2独立公立大学医院接受治疗的患者中PDRP的发病率、致病病原体及治疗反应。
在36个月内,89例接受腹膜透析的患者中有18例发生了20次腹膜炎事件。
PDRP的发病率为1次/32患者 - 月,其中45%的PDRP事件由革兰氏阳性菌引起,40%由革兰氏阴性菌引起,5%由真菌引起。金黄色葡萄球菌是革兰氏阳性菌中最常见的病原体,产酸克雷伯菌和阴沟肠杆菌在革兰氏阴性菌中同样常见。标准治疗的成功率令人满意(80%);在20%的PDRP病例中需要拔除Tenckhoff导管。
与其他中心的数据相比,可以观察到革兰氏阴性菌引起的PDRP比例更高。分离菌株对第三代头孢菌素和喹诺酮类药物高度敏感。该中心PDRP的低发病率以及引起该疾病的菌株的细菌学特征证实了患者的高素质和培训质量以及透析导管的正确插入。