Clinical Features Of Peritoneal Dialysis-related Peritonitis And Drug Resistance Analysis

BackgroundPD for some of its own characteristics and advantages, is accepted bymore and more people, but peritonitis is still the most common complication ofperitoneal dialysis, and the main reason for resulting in hospitalization rates,mortality, and exiting peritoneal dialysis.Long-term heavy use of antimicrobialdrugs, microorganisms composition spectrum change constantly, and resistantstrains are also increasing.So to understand the clinical features of PDcorrelation peritonitis, pathogenic bacteria and change of drug resistance rate isclinically practical problems we faced.In this paper, the analysis of the relevantfactors to guide clinical practice for the appropriate factors to take effectivemeasures to improve the cure rate of hospital infections, improve the quality ofpeople’s lives.ObjectiveA retrospective analysis of the First Hospital of Jilin University bipartitenearly two years of continuous ambulatory peritoneal dialysis (CAPD) patientswith peritonitis associated clinical data, and summarizes the general clinicalfeatures of peritonitis, pathogenic bacteria peritonitis spectrum and resistance tochange, to provide basis for clinical treatment of peritonitis.Materials and MethodsPatients in the first hospital of jilin university who experienced peritonitiswere observed as peritonitis group，Patients did not experience peritonitis wereobserved as control group，Simultaneous analysis of peritonitis group ofpathogens and drug resistance rate of change,To investigate the clinical features of peritonitis, flora distribution and drug resistance rate.Results（1）Two groups of patient’s age, gender, marital status, the mode ofpayment,dialysis month, no difference between the baseline data, such as theprimary diseases；（2）The number of white blood cells in peripheral blood of peritonitisgroup was significantly higher than the control group (P<0.01), the proportionof neutrophils in peritonitis group was also significantly higher (P<0.01),peritonitis group of red blood cells, hemoglobin was significantly lower thanthe control group (P<0.05);（3）Peritonitis group serum potassium, sodium, chloride, calcium levelsare lower than the control group (P <0.05); peritonitis group phosphorus is alsolower than the control group, but no significant difference between the twogroups (P>0.05);（4）Serum albumin levels in patients with peritonitis group wasobviously lower than the control group (P<0.05). Prealbumin peritonitis groupis lower than the control group, but there was no statistically significantdifference (P>0.05).Ferritin level peritonitis group were significantly higherthan the control group (P<0.01)（5）Peritonitis group and the control group in the dialysis tube exitlocation (right/left), the difference was not statistically significant (P>0.05);no significant difference between the two groups in catheterization hospital(our hospital/outside the hospital)(P>0.05)；diarrhea/constipation inperitonitis group are higher than the control group，There was statisticallysignificant (P <0.01)；Serum creatinine peritonitis group than the control group,no statistical significance between the two groups (P>0.05), but peritonitisgroup urea nitrogen than the control group between the two groups was statistically significant (P <0.01)（6）In57patients with CAPD peritonitis, a total of42cases culturepositive, the positive rate was73.68%, a total of training46strains pathogenicbacteria, including19strains of gram-positive bacteria, accounting for41.30%,20strains of gram-negative bacteria, accounting for43.48%;Fungus7strains,accounting for15.22%,Which mixed infection in3patients,2patientsdeveloped two kinds of pathogenic bacteria,1patients developed three kinds ofpathogenic bacteria.（7）The main gram-positive bacteria to linezolid, teicoplanin, vancomycinresistance to a minimum, were0;followed nitrofurantoin, amikacin,respectively,7.14%,14.29%;Penicillin, oxacillin methicillin resistance rateswere63.16%,71.43%, erythromycin resistantance rate as high as72.22%,Gram-negative bacteria were not found to amikacin, imipenem,cefoperazone-resistant strains; ceftazidime, amoxicillin (clavulanic acid)resistance rate of20%,35.29%respectively; Ampicillin resistance to thehighest, at81.25%.（8）A total of three cases of50patients died, seven cases of extubationchanged to hemodialysis, the remaining patients were cured, CAPD exit rate of14percent, the study seven cases of fungal peritonitis, four cases of extubationchanged to hemodialysis, three deaths.（9）Cases of fungal peritonitis PD time significantly longer than G+andG-bacteria peritonitis;White blood cell count was significantly higher thantwo kinds of bacterial peritonitis patients (P<0.05).Conclusion1、Electrolyte imbalance, poor nutrition, anemia is the risk factor ofperitonitis.2、Peritoneal dialysis-related peritonitis pathogens: Gram-negative bacteria composition ratio was43.48%, proportion of Gram-positive bacteria was41.30%Ratio of15.22%for the fungus.3、Experience in the treatment of patients with peritonitis, antibiotics maycontinue to use vancomycin and ceftazidime, cefazolin resistance ratesincreased.4、Fungal peritonitis had a higher mortality rate and exit rate.