Záruba K, Peters J, Jungbluth H
Renal Center, City Hospital Waid Zurich, Switzerland.
Am J Kidney Dis. 1991 Jan;17(1):43-6. doi: 10.1016/s0272-6386(12)80249-6.
Fungal peritonitis as a serious complication of continuous ambulatory peritoneal dialysis (CAPD) is often associated with severe morbidity, CAPD "drop-out" and, occasionally, death. Most episodes of fungal peritonitis occur during or after a period of antibiotic treatment of various bacterial infections, usually bacterial peritonitis. From April 1979 to December 1982 (period I), 10 episodes of fungal peritonitis occurred during 415 patient-months, ie, 10.5% of all peritonitis episodes recorded in our CAPD program. After the introduction of oral prophylaxis with 3 x 500,000 IU [corrected] nystatin during every course of antibiotic treatment, only four episodes of fungal peritonitis occurred during 2,102 patient-months, ie, 3.1% of all peritonitis episodes from January 1983 to March 1989 (period II). This difference between the first and second periods is significant (P less than 0.05). Moreover, none of the four patients who contracted fungal peritonitis in the second period received nystatin prophylaxis. Thus, the simple measure of oral prophylaxis using this nonabsorbable antifungal agent in every case of an antibiotic treatment largely eliminates the risk of fungal peritonitis in patients on CAPD.
真菌性腹膜炎作为持续性非卧床腹膜透析（CAPD）的一种严重并发症，常伴有严重的发病情况、CAPD“退出”，偶尔还会导致死亡。大多数真菌性腹膜炎发作发生在各种细菌感染（通常是细菌性腹膜炎）的抗生素治疗期间或之后。1979年4月至1982年12月（第一阶段），在415个患者月期间发生了10例真菌性腹膜炎，即占我们CAPD项目中记录的所有腹膜炎发作的10.5%。在每次抗生素治疗过程中引入口服3×500,000 IU制霉菌素进行预防后，在2102个患者月期间仅发生了4例真菌性腹膜炎，即占1983年1月至1989年3月所有腹膜炎发作的3.1%（第二阶段）。第一阶段和第二阶段之间的这种差异具有显著性（P小于0.05）。此外，第二阶段感染真菌性腹膜炎的4名患者中没有一人接受制霉菌素预防。因此，在每例抗生素治疗中使用这种不可吸收的抗真菌剂进行口服预防的简单措施，在很大程度上消除了CAPD患者发生真菌性腹膜炎的风险。
