Bernardini J, Piraino B, Sorkin M
Department of Internal Medicine, University of Pittsburgh, Pennsylvania.
Am J Med. 1987 Nov;83(5):829-32. doi: 10.1016/0002-9343(87)90638-3.
The outcomes of all continuous ambulatory peritoneal dialysis-related infections due to Pseudomonas aeruginosa (n = 33) were analyzed and compared with the outcomes of infections due to all other microorganisms (n = 663) over a seven-year period. There were 16 catheter infections (exit site or tunnel infection or both), seven episodes of peritonitis, and 10 episodes of catheter infections associated with peritonitis due to P. aeruginosa. Catheters were removed in 58 percent (19 of 33) of the infections due to P. aeruginosa, but in only 16 percent (104 of 663) of the infections due to other organisms (p less than 0.01). All P. aeruginosa catheter infections associated with P. aeruginosa peritonitis resulted in catheter loss. P. aeruginosa catheter infections not associated with peritonitis also often did not resolve with antibiotic therapy (nine of 16 or 56 percent of catheters removed compared with 42 of 317 or 13 percent of catheters removed for other organisms, p less than 0.01). However, P. aeruginosa peritonitis episodes that were not associated with a catheter infection were no more likely to result in catheter loss than were peritonitis episodes due to other organisms (one of seven compared with 37 of 256, 14 percent for both). It is concluded that catheter infections due to P. aeruginosa with or without associated peritonitis usually require catheter removal. Conversely, P. aeruginosa peritonitis without a catheter infection often does not require catheter removal.
对七年间所有由铜绿假单胞菌引起的持续性非卧床腹膜透析相关感染（n = 33）的结果进行了分析，并与所有其他微生物引起的感染（n = 663）的结果进行了比较。由铜绿假单胞菌引起的感染中有16例导管感染（出口部位或隧道感染或两者兼有）、7例腹膜炎发作以及10例与腹膜炎相关的导管感染。在由铜绿假单胞菌引起的感染中，58%（33例中的19例）的导管被拔除，但在由其他微生物引起的感染中，只有16%（663例中的104例）的导管被拔除（p<0.01）。所有与铜绿假单胞菌腹膜炎相关的铜绿假单胞菌导管感染均导致导管丢失。与腹膜炎无关的铜绿假单胞菌导管感染通常也不能通过抗生素治疗得到解决（16例中有9例或56%的导管被拔除，相比之下，317例中有42例或13%的导管因其他微生物感染被拔除，p<0.01）。然而，与导管感染无关的铜绿假单胞菌腹膜炎发作导致导管丢失的可能性并不比其他微生物引起的腹膜炎发作更高（7例中有1例，相比之下，256例中有37例，两者均为14%）。结论是，无论有无相关腹膜炎，由铜绿假单胞菌引起的导管感染通常都需要拔除导管。相反，无导管感染的铜绿假单胞菌腹膜炎通常不需要拔除导管。
