Coles G A
Institute of Nephrology, Cardiff Royal Infirmary, Wales, UK.
J Chemother. 1995 Jul;7 Suppl 3:67-70.
Peritoneal dialysis is in widespread use for the treatment of chronic renal failure. Infection is still one of the major complications and can include peritonitis and pericannular problems. The rate of peritonitis is currently 0.5 episodes per patient year with disconnect systems, and there are about 0.4 exit-site infections (ESIs) per patient year. ESI is associated with a high rate of catheter removal and replacement. Staphylococcus aureus is a common cause of peritonitis and accounts for more than half of all ESIs. Nasal carriage of S. aureus is associated with a much higher rate of ESI. Treatment of ESIs is unsatisfactory. The type of exit-site care, however, does influence the rate of infection and prophylaxis with oral rifampicin and local or nasal mupirocin has been claimed to reduce ESIs. A large multicentre double-blind trial of nasal mupirocin has just been completed and preliminary results show a reduction in the incidence of S. aureus-induced ESI. The cost benefits of such a regimen are being evaluated.
腹膜透析在慢性肾衰竭的治疗中被广泛应用。感染仍然是主要并发症之一，包括腹膜炎和导管周围问题。目前，采用断开连接系统时，腹膜炎的发生率为每位患者每年0.5次发作，每位患者每年约有0.4次出口部位感染（ESI）。ESI与高比例的导管拔除和更换相关。金黄色葡萄球菌是腹膜炎的常见病因，占所有ESI的一半以上。鼻腔携带金黄色葡萄球菌与更高的ESI发生率相关。ESI的治疗效果并不理想。然而，出口部位护理的类型确实会影响感染率，据称口服利福平以及局部或鼻腔使用莫匹罗星进行预防可降低ESI。一项关于鼻腔使用莫匹罗星的大型多中心双盲试验刚刚完成，初步结果显示金黄色葡萄球菌引起的ESI发生率有所降低。正在评估这种治疗方案的成本效益。
