Møller J K, Hagelskjaer L H
Klinisk mikrobiologisk afdeling, Arhus Kommunehospital.
Ugeskr Laeger. 1996 Apr 29;158(18):2538-41.
Conventional aerobic and anaerobic culture of peritoneal dialysate effluent from patients in continuous peritoneal dialysis (CAPD) was compared to culture in a semiautomated blood culture system. During a two-year period 78 of 79 consecutive episodes of peritonitis among 45 Danish CAPD patients were cultured and the etiology of the infection found in 73 (94%). The sensitivity of the blood culture system was 88%, whereas the sensitivity of the conventional culture of the dialysate effluent was 81%. This difference is not significant (McNemar test; 0.5 > p > 0.3). The majority of isolates were Gram-positive bacteria dominated by coagulase-negative staphylococci (38%). In comparison, only 2% of the cultures of peritoneal dialysate effluent taken within the same period from patients without clinical signs of peritonitis were positive. All the Gram-positive aerobic bacteria were sensitive to vancomycin whereas 97% of the Gram-negative aerobic bacteria were sensitive to gentamicin. An initial empiric treatment of peritonitis with a combination of vancomycin and gentamicin is recommended.
将持续性非卧床腹膜透析（CAPD）患者的腹膜透析流出液进行传统需氧和厌氧培养，并与半自动血培养系统中的培养结果进行比较。在两年期间，对45名丹麦CAPD患者连续发生的79次腹膜炎发作中的78次进行了培养，73次（94%）发现了感染病因。血培养系统的敏感性为88%，而透析流出液传统培养的敏感性为81%。这种差异不显著（McNemar检验；0.5＞p＞0.3）。大多数分离株为革兰氏阳性菌，以凝固酶阴性葡萄球菌为主（38%）。相比之下，同期从无腹膜炎临床症状的患者采集的腹膜透析流出液培养物中只有2%呈阳性。所有革兰氏阳性需氧菌对万古霉素敏感，而97%的革兰氏阴性需氧菌对庆大霉素敏感。建议用万古霉素和庆大霉素联合进行腹膜炎的初始经验性治疗。
