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四个土耳其中心腹膜透析患者中的真菌性腹膜炎

Fungal peritonitis among the peritoneal dialysis patients of four Turkish centres.

作者信息

Kazancioglu Rumeyza, Kirikci Gulbahar, Albaz Muserref, Dolgun Rukiye, Ekiz Serpil

机构信息

Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey.

出版信息

J Ren Care. 2010 Dec;36(4):186-90. doi: 10.1111/j.1755-6686.2010.00193.x.

Abstract

This study evaluates the clinical findings and treatment of continuous ambulatory peritoneal dialysis (CAPD) patients with fungal peritonitis in Istanbul from 2000 to 2010. The clinical records of 15 patients with fungal peritonitis among the total 795 patients were reviewed for the clinical and laboratory data. The mean duration of dialysis from the initiation of treatment until the development of fungal peritonitis was 41.14 months. Fungal peritonitis was the primary episode of infection in eight patients. In five other patients previous intensive antibiotherapy was documented. The isolated mircoboes were Candida albicans in six, non-C. albicans in eight and Aspergillus fumigatus in one patient. Tenckoff catheters were removed in all cases and antifungal treatment was given for a minimum of three weeks. Two patients died in the hospital due to the fungal infection whereas others were transferred to haemodialysis. This study highlights the importance of removing the catheter and initiating antifungal therapy as soon as possible in cases of fungal peritonitis because it is responsible for high morbidity and mortality.

摘要

本研究评估了2000年至2010年期间伊斯坦布尔持续性非卧床腹膜透析(CAPD)患者真菌性腹膜炎的临床发现及治疗情况。在总共795例患者中,对15例真菌性腹膜炎患者的临床记录进行了回顾,以获取临床和实验室数据。从开始治疗到发生真菌性腹膜炎的平均透析时间为41.14个月。真菌性腹膜炎是8例患者的原发性感染发作。在另外5例患者中,有先前强化抗微生物治疗的记录。分离出的微生物中,6例为白色念珠菌,8例为非白色念珠菌,1例为烟曲霉。所有病例均拔除了Tenckoff导管,并给予至少三周的抗真菌治疗。2例患者因真菌感染在医院死亡,其他患者则转为血液透析。本研究强调了在真菌性腹膜炎病例中尽快拔除导管并开始抗真菌治疗的重要性,因为它会导致高发病率和死亡率。

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