Oxton L L, Zimmerman S W, Roecker E B, Wakeen M
Department of Medicine, University of Wisconsin, Madison 53792.
Perit Dial Int. 1994;14(2):137-44.
To identify factors associated with peritoneal dialysis-related infections at one center.
The study was a retrospective study of a 3-year time period with relatively stable treatment patterns.
A single center experienced academic peritoneal dialysis program.
Patients (N = 163) receiving peritoneal dialysis (PD) from January 1989 to December 1991 who had received treatment at home for at least one month.
None.
Catheter-related infection and peritonitis were the main outcome measures. Variables affecting infection rates that were assessed included age, time on PD, prior end-stage renal disease (ESRD) therapy, diabetic status, catheter type, exchange device, nasal carriage of S. aureus, and prophylactic rifampin therapy. Data were analyzed with univariate as well as with a fixed-effects and a mixed-effects gamma-Poisson multiple regression model.
Variables associated with an increased risk of new peritonitis included age under 20 years (p < 0.009; rate ratio 4.54) and nasal carriage of S. aureus (p < 0.04; rate ratio 1.75). Decreased new peritonitis risk was associated with the ULTRA Set exchange system (p < 0.008; risk ratio 0.38) and intermittent prophylactic rifampin therapy (p < 0.001; rate ratio 0.99 for each 1% time on therapy). Catheter-related infections were increased in patients who had double-cuff catheters (p < 0.003) and nasal carriage of S. aureus (p < 0.04; rate ratio 1.82). Decreased catheter-related infections were noted in older patients (p < 0.02; rate ratio 0.983/year) and increasing months of study follow-up (p < 0.03; rate ratio 0.97/month).
In our program nasal carriage of S. aureus increased the risk of peritonitis and catheter-related infection. Prophylactic rifampin significantly decreased peritonitis, as did use of the ULTRA Set. Single-cuff opaque catheters had the lowest catheter infection rate. Analysis of the relationships between clinical and demographic variables and peritoneal dialysis-related infection rate can identify significant contributing or protective variables and allow peritoneal dialysis programs to develop preventive strategies to minimize the risk of infection.
确定某一中心与腹膜透析相关感染有关的因素。
本研究是一项回顾性研究，为期3年，治疗模式相对稳定。
一个经验丰富的单中心腹膜透析项目。
1989年1月至1991年12月期间接受腹膜透析（PD）且在家接受治疗至少1个月的患者（N = 163）。
无。
与导管相关的感染和腹膜炎是主要观察指标。评估的影响感染率的变量包括年龄、腹膜透析时间、既往终末期肾病（ESRD）治疗情况、糖尿病状态、导管类型、交换装置、金黄色葡萄球菌鼻腔携带情况以及预防性利福平治疗。数据采用单变量分析以及固定效应和混合效应伽马-泊松多元回归模型进行分析。
与新发腹膜炎风险增加相关的变量包括20岁以下年龄（p < 0.009；率比4.54）和金黄色葡萄球菌鼻腔携带（p < 0.04；率比1.75）。新发腹膜炎风险降低与ULTRA Set交换系统有关（p < 0.008；风险比0.38）以及间歇性预防性利福平治疗（p < 0.001；每次治疗时间每增加1%，率比0.99）。双套囊导管患者的导管相关感染增加（p < 0.003）以及金黄色葡萄球菌鼻腔携带（p < 0.04；率比1.82）。老年患者的导管相关感染减少（p < 0.02；率比0.983/年）以及研究随访月数增加（p < 0.03；率比0.97/月）。
在我们的项目中，金黄色葡萄球菌鼻腔携带增加了腹膜炎和导管相关感染的风险。预防性利福平以及使用ULTRA Set显著降低了腹膜炎的发生。单套囊不透明导管的导管感染率最低。分析临床和人口统计学变量与腹膜透析相关感染率之间的关系可以确定显著的促成或保护变量，并使腹膜透析项目能够制定预防策略以尽量降低感染风险。
