持续性非卧床腹膜透析患者的假单胞菌性腹膜炎：治疗失败的实验室预测指标

Pseudomonas peritonitis in continuous ambulatory peritoneal dialysis: laboratory predictors of treatment failure.

作者信息

Craddock C F, Edwards R, Finch R G

机构信息

Department of Microbiology, University of Nottingham.

出版信息

J Hosp Infect. 1987 Sep;10(2):179-86. doi: 10.1016/0195-6701(87)90145-9.

DOI:10.1016/0195-6701(87)90145-9

PMID:2889772

Abstract

Five episodes of pseudomonas peritonitis complicating continuous ambulatory peritoneal dialysis (CAPD) which were not cured by intraperitoneal antibiotics were studied to assess causes for treatment failure. The activity of gentamicin and ceftazidime against these strains was decreased in the presence of sterile used dialysate compared with nutrient broth. Likewise, kinetic studies showed that in dialysate therapeutically used concentrations of antibiotics failed to kill the isolates over 24 h. All five pseudomonas strains were adherent to silicone rubber Tenckoff catheter segments. An in vitro model of CAPD peritonitis demonstrated that persistence of viable adherent bacteria, after exposure to therapeutic concentrations of gentamicin and ceftazidime, contributes to the failure of antibiotics to cure pseudomonas CAPD peritonitis.

摘要

研究了5例因持续性非卧床腹膜透析（CAPD）并发假单胞菌性腹膜炎且经腹腔内抗生素治疗未治愈的病例，以评估治疗失败的原因。与营养肉汤相比，在无菌使用的透析液存在的情况下，庆大霉素和头孢他啶对这些菌株的活性降低。同样，动力学研究表明，在透析液中治疗浓度的抗生素在24小时内未能杀死分离株。所有5株假单胞菌均附着于硅橡胶Tenckhoff导管段。CAPD腹膜炎的体外模型表明，在暴露于治疗浓度的庆大霉素和头孢他啶后，存活的附着细菌持续存在是抗生素治疗假单胞菌性CAPD腹膜炎失败的原因。