Piraino B
Department of Medicine, University of Pittsburgh School of Medicine, Presbyterian University Hospital, PA 15213, USA.
Blood Purif. 1995;13(3-4):171-9. doi: 10.1159/000170200.
There are many promising areas of research on peritoneal dialysis related infections. Improvements in connection technology, especially the Y set and CCPD, have led to a decrease in the rate of peritonitis due to Staphylococcus epidermidis. The search to find a more biocompatible dialysate that is less immunocompromising is underway; clinical trials examining peritonitis rates with these new formulations remain to be performed. Considerable progress has been made in elucidating peritonitis related to catheter infection, especially that due to Staphylococcus aureus. Nasal carriage has been identified as a risk factor for subsequent infections. Several prophylactic antibiotic approaches including rifampin, trimethoprim/sulfamethoxazole and mupirocin have shown promise in reducing these infections. Innovative catheter designs that decrease the risk of bacterial colonization are another investigative approach. The timing of both catheter removal and replacement for infection is controversial and requires further study. Lastly, much remains to be learned about peritonitis from an enteric source.
腹膜透析相关感染有许多很有前景的研究领域。连接技术的改进，尤其是Y型装置和持续循环腹膜透析（CCPD），已使表皮葡萄球菌所致腹膜炎的发生率有所下降。目前正在寻找生物相容性更好、免疫抑制作用更小的透析液；仍有待开展临床试验来检测这些新配方透析液的腹膜炎发生率。在阐明与导管感染相关的腹膜炎方面，尤其是金黄色葡萄球菌所致的腹膜炎，已经取得了相当大的进展。鼻腔带菌已被确定为后续感染的一个危险因素。包括利福平、甲氧苄啶/磺胺甲恶唑和莫匹罗星在内的几种预防性抗生素方法在降低这些感染方面已显示出前景。降低细菌定植风险的创新性导管设计是另一种研究方法。因感染而拔除和更换导管的时机存在争议，需要进一步研究。最后，关于肠道源性腹膜炎仍有许多有待了解之处。
