Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Clin J Am Soc Nephrol. 2011 Apr;6(4):827-33. doi: 10.2215/CJN.05370610. Epub 2010 Dec 23.
The clinical behavior of repeat-peritonitis episodes, defined as peritonitis with the same organism occurring more than 4 weeks after completion of therapy for a prior episode, is poorly understood.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We compared outcomes of 181 episodes of repeat peritonitis from 1995 to 2009 (Repeat Group) with 91 episodes of relapsing peritonitis (Relapsing Group) and 125 episodes of peritonitis preceded 4 weeks or longer by another episode with a different organism (Control Group).
In Repeat Group, 24% were due to Staphylococcus aureus, as compared with 5.5% in Relapsing Group and 15% in Control Group. The majority of the organisms causing relapsing peritonitis were Gram negative (62%), whereas the majority of that in Repeat Group were Gram positive (56%). Repeat Group had a lower complete-cure rate (70.7% versus 54.9%) than Relapsing Group, but rates of primary response, catheter removal, and mortality were similar. Repeat Group had a higher primary response rate (89.0% versus 73.6%) and a lower rate of catheter removal (6.1% versus 15.2%) than Control Group, whereas the complete-cure rate and mortality were similar. Repeat Group had a higher risk of developing relapsing (14.3% versus 2.2%) and repeat peritonitis (26.1% versus 5.4%) than Control Group, whereas the risk of recurrent peritonitis was similar.
Repeat peritonitis is a distinct clinical entity. Although repeat-peritonitis episodes generally have a satisfactory response to antibiotic, they have a substantial risk of developing further relapsing or repeat peritonitis.
反复发作性腹膜炎是指在完成前一次腹膜炎的治疗后 4 周以上，同一病原体再次引起腹膜炎。目前对其临床特征尚缺乏了解。
设计、地点、参与者和测量方法：我们比较了 1995 年至 2009 年 181 例反复发作性腹膜炎（重复组）与 91 例复发性腹膜炎（复发组）和 125 例间隔 4 周或更长时间、由不同病原体引起的腹膜炎（对照组）的结局。
重复组中 24%由金黄色葡萄球菌引起，而复发组中为 5.5%，对照组中为 15%。引起复发性腹膜炎的大多数病原体为革兰阴性菌（62%），而重复组中的大多数病原体为革兰阳性菌（56%）。与复发组（70.7%）相比，重复组的完全治愈率较低（54.9%），但初次反应率、导管去除率和死亡率相似。与对照组相比，重复组初次反应率较高（89.0% vs. 73.6%），导管去除率较低（6.1% vs. 15.2%），而完全治愈率和死亡率相似。与对照组相比，重复组发生复发（14.3% vs. 2.2%）和再次发生腹膜炎（26.1% vs. 5.4%）的风险更高，而复发腹膜炎的风险相似。
反复发作性腹膜炎是一种独特的临床实体。尽管反复发作性腹膜炎通常对抗生素有满意的反应，但它们有发生进一步复发或再次发生腹膜炎的很大风险。
