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接受自动化腹膜透析的儿童的腹膜炎

Peritonitis in children with automated peritoneal dialysis.

作者信息

Alharthi Abdulla A

出版信息

Clin Nephrol. 2015 Nov;84(5):289-94. doi: 10.5414/CN108631.

Abstract

This is a retrospective study including 36 Saudi children who were on automated peritoneal dialysis (APD) at the Al-Hada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia during seven years. A total of 10 boys and 26 girls with end-stage renal disease (ESRD) received APD for a total of 731.75 months. 36 episodes of peritonitis occurred in 17 children (47%). The frequency of peritonitis was one episode per 20.3 treatment months. Catheters were changed in 3 patients (8%). Three patients were switched to chronic hemodialysis, while 4 underwent successful renal transplantation. Results revealed that 11 patients (19%) were culturenegative, while 25 (81%) were culturepositive. Gram-positive organisms were responsible for the majority of peritonitis episodes (50%) followed by Gram-negative organisms (31%); occurrence was more frequent in young patients. Empiric antibiotic therapy covered both gram-positive and gram-negative organisms. However, all gram-positive isolated microorganisms showed sensitivity to vancomycin. On the other hand, most gram-negative organisms showed sensitivity to ceftazidime or tobramycin.

摘要

这是一项回顾性研究,纳入了沙特阿拉伯王国塔伊夫市哈达武装部队医院7年间接受自动腹膜透析(APD)治疗的36名沙特儿童。共有10名男孩和26名患有终末期肾病(ESRD)的女孩接受了APD治疗,累计治疗时长为731.75个月。17名儿童(47%)发生了36次腹膜炎。腹膜炎的发生率为每20.3个治疗月发生1次。3例患者(8%)更换了导管。3例患者转为慢性血液透析,4例成功接受了肾移植。结果显示,11例患者(19%)培养结果为阴性,25例(81%)培养结果为阳性。革兰氏阳性菌是导致大多数腹膜炎发作的原因(50%),其次是革兰氏阴性菌(31%);在年轻患者中发生率更高。经验性抗生素治疗覆盖了革兰氏阳性菌和革兰氏阴性菌。然而,所有分离出的革兰氏阳性微生物均对万古霉素敏感。另一方面,大多数革兰氏阴性菌对头孢他啶或妥布霉素敏感。

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