Analysis Of Risk Factors,Pathogens And Drug Resistance Of Peritoneal Dialysis-accociated Peritonitis

Objective:To retrospectively analyze the etiology of peritoneal dialysis-associated peritonitis and the clinical characteristics of frequent peritoneal dialysis-associated peritonitis in Yiyang Central Hospital.Methods:To collect general information,biochemical parameters,peritoneal dialysis-associated peritonitis(PD)culture and drug sensitivity test results of 120 patients hospitalized in the Department of Nephrology of Yiyang Central Hospital from 1st August 2014 to 31 st July 2018,the general data were analyzed by rank sum test,biochemical index and drug resistance by homo-geneity of variance test,and the general data and biochemical index were analyzed by logistic regression.Results:1.There were 194 peritonitis cases and 113 positive cases(positive rate: 58.25%),of which 72 cases were Gram-positive,accounting for 63.72% of positive strains,staphylococcus epidermidis(24 cases),hemolytic Staphylococci(12 cases),Staphylococcus aureus(10cases),Gram-negative(28 cases)accounted for 24.78% of the positive strains,Escherichla coli(10 cases),Klebsiella penumoniae(9 cases),fungi(13 cases),accounting for 11.50% of the positive strains,with Candida Albicans(7 cases),near Smooth Candida(4 cases).Compared with single peritonitis group,frequent peritonitis group had no significant difference in the distribution of pathogens.2.Gram-positive bacteria were more sensitive to Rifampicin,Vancomycin,nitrofurantoin and tegecycline,while gram-negative bacteria were more sensitive to imine,Amikacin,Cefotetan,Meropenem and CEFTAZIDIME,the fungi were sensitive to Amphotericin B,fluconazole and Voriconazole.Compared with the single peritonitis group,the gram-positive bacteria in the frequent peritonitis group were highly resistant to Ciprofloxacin,tetracycline,gentamicin,oxacillin,Azithromycin,oxacillin,CEFOTAXIME and Trimet-hoprim(P>0.05).The drug resistance rate of gram-negative bacteria in the two groups was not statistically significant(P<0.05).3.Compared with single peritonitis group and frequent peritonitis group,there were no significant differences in sex,age,primary disease,reimbursement method,blood pressure,blood potassium,blood calcium,blood phosphorus,PTH,uric acid,white blood cells,platelets,neutrophil and lymphocyte(P>0.05).In the group with frequent peritonitis,the penetration age,neutrophil lymphocyte ratio,platelet lymphocyte ratio were higher than those in the group with single peritonitis,and the levels of urea,serum Creatinine,Alb and hemoglobin were lower than those in the group with single peritonitis,the difference was statistically significant(P<0.05).4.Logistic Regression analysis showed that neutrophil lymphocyte ratio and lymphocyte ratio were independent clinical features of frequent peritonitis compared with single peritonitis.The OR values are 4.796 and 2.943,respectively.Conclusion:1.Compared with the single peritonitis group,the frequent peritonitis group had higher rates of resistance to Ciprofloxacin,tetra cycline,gentamicin,oxacillin,Azithromycin,oxacillin,cefpodoxime and Trimethoprim.2.Compared with the single peritonitis group,inflammatory state and malnutrition were the independent clinical features of frequent peritonitis.