巴斯德氏菌属引起的腹膜透析相关性腹膜炎：家庭宠物作为一个危险因素。
Pasteurella species peritoneal dialysis-associated peritonitis: Household pets as a risk factor.
机构信息
Section of Paediatric Infectious Diseases, Department of Paediatrics and Child Health;
Department of Medical Microbiology and Infectious Diseases, University of Manitoba; ; Department of Clinical Microbiology, St Boniface General Hospital;
出版信息
Can J Infect Dis Med Microbiol. 2015 Jan-Feb;26(1):52-5. doi: 10.1155/2015/389467.
BACKGROUND
Pasteurella species are Gram-negative coccobacilli that are a part of the normal oropharyngeal flora of numerous domestic animals. They have been recognized as a rare but significant cause of peritonitis in patients undergoing peritoneal dialysis (PD). A consensus about management strategies for PD-associated peritonitis caused by Pasteurella species currently does not exist.
METHODS
The microbiological database serving the Manitoba Renal Program was searched from 1997 to 2013 for cases of Pasteurella species PD-associated peritonitis, and charts were reviewed. PubMed was searched for case reports and data were abstracted.
RESULTS
Seven new local cases and 30 previously reported cases were analyzed. This infection is clinically similar to other forms of PD peritonitis, with household pet exposure appearing to be the strongest risk factor. Cats are the most commonly implicated pet. Direct contact between the pet and the equipment was commonly reported (25 of 37 patients) but was not necessary for infection to develop. The mean duration of treatment was 15 days. Complication rates were low, with only 11% of patients requiring PD catheter removal. There was no mortality reported.
CONCLUSION
Pasteurella species are a rare cause of PD-associated peritonitis that can be successfully treated with a two-week course of intraperitoneal antibiotics with a high likelihood of catheter salvage.
背景
巴氏杆菌属是革兰氏阴性球杆菌，是许多家畜的口咽正常菌群的一部分。它们已被认为是腹膜透析（PD）患者腹膜炎的罕见但重要原因。目前，对于由巴氏杆菌属引起的 PD 相关性腹膜炎的管理策略尚无共识。
方法
从 1997 年至 2013 年，对曼尼托巴省肾脏计划的微生物学数据库进行了搜索，以查找巴氏杆菌属 PD 相关性腹膜炎的病例，并对图表进行了审查。在 PubMed 上搜索了病例报告，并提取了数据。
结果
分析了 7 例新的本地病例和 30 例以前报告的病例。这种感染在临床上与其他形式的 PD 腹膜炎相似，家庭宠物暴露似乎是最强的危险因素。猫是最常涉及的宠物。经常报告宠物与设备之间的直接接触（37 例患者中有 25 例），但并非感染发生的必要条件。平均治疗时间为 15 天。并发症发生率低，只有 11％的患者需要去除 PD 导管。无死亡报告。
结论
巴氏杆菌属是 PD 相关性腹膜炎的罕见病因，用两周疗程的腹腔内抗生素治疗可成功治疗，并且很可能挽救导管。
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