Bacterial spectrum and drug resistance analysis of pathogens in peritoneal dialysis associated peritonitis_West China Medical Journal

Authors：

ZHOU Xueli , QIN Min , REN Ying , LI Li , DIAO Yongshu , TANG Xiaohong , ZHONG Hui ,  LI Zi

Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Zi, Email: lizihx@163.com

Keywords：

Peritoneal dialysis; Peritonitis; Drug resistance

DOI：

10.7507/1002-0179.201509057

Video：

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Objective To investigate the change of pathogenic distribution and drug resistance in peritoneal dialysis associated peritonitis (PDAP). Methods The clinical data of all the patients undergoing continuous ambulatory peritoneal dialysis and suffered from PDAP between January and December in 2014 was retrospectively collected, and the pathogens, drug resistance, outcomes and underlying causes were analyzed. Results A total of 64 patients had 72 cases of PDAP. Only 36 strains (50.0%) had positive culture results, among which 24 strains (66.7%) were Gram-positive bacteria strains, 7 strains (19.4%) were Gram-negative bacteria strains, and 5 strains (13.9%) were fungi. For Gram-positive bacteria strains, the resistance rates to vancomycin, linezolid and rifampicin were all 0%; the resistance rate to levofloxacin, gentamycin and cefazolin was 14.3%, 26.3% and 50.0%, respectively. For Gram-negative bacteria strains, the resistance rates to amikacin and imipenem were both 0%; the resistant rate to gentamycin, ceftazidime, levofloxacin and ampicillin was 28.6%, 28.6%, 42.9% and 100.0%, respectively. Conclusions The pathogenic spectrum and drug resistance in PDAP have been markedly changed. Selection of antibiotics should be chosen according to the characteristic of the pathogenic spectrum and drug resistance of each center. Great effort is still needed to improve the culture positive rate of the effluent dialysate and to improve the recovery rate of peritonitis.

Citation： ZHOU Xueli, QIN Min, REN Ying, LI Li, DIAO Yongshu, TANG Xiaohong, ZHONG Hui, LI Zi. Bacterial spectrum and drug resistance analysis of pathogens in peritoneal dialysis associated peritonitis. West China Medical Journal, 2017, 32(8): 1221-1224. doi: 10.7507/1002-0179.201509057 Copy

1.	Jain AK, Blake P, Cordy P, et al. Global trends in rates of peritoneal dialysis. J Am Soc Nephrol, 2012, 23(3): 533-544.
2.	Verger C, Ryckelynck JP, Duman M, et al. French peritoneal dialysis registry (RDPLF): outline and main results. Kidney Int Suppl, 2006, 103(13): S12-S20.
3.	Mujais S, Story K. Peritoneal dialysis in the US: evaluation of outcomes in contemporary cohorts. Kidney Int Suppl, 2006, 103(13): S21-S26.
4.	Li PK, Szeto CC, Piraino B, et al. Peritoneal dialysis-related infections recommendations: 2010 update. Perit Dial Int, 2010, 30(4): 393-423.
5.	张明峰, 邱启泽, 李明宇, 等. 纸片扩散法与细菌鉴定系统的药敏结果比较. 中国医师杂志, 2011, 4(31): 123-124.
6.	Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the United States. JAMA, 2007, 298(17): 2038-2047.
7.	Muñoz De Bustillo E, Borrás F, Gómez-Roldán C, et al. Impact of peritonitis on long-term survival of peritoneal dialysis patients. Nefrologia, 2011, 31(6): 723-732.
8.	Piraino B. Peritoneal dialysis infections recommendations. Contrib Nephrol, 2006, 150: 181-186.
9.	Bulut C, Oztürk R, Yilmaz GR, et al. Evaluation of the epidemiological, clinical and laboratory findings in continuous ambulatory peritoneal dialysis related peritonitis attacks. Mikrobiyol Bul, 2008, 42(2): 255-264.
10.	Huang ST, Chuang YW, Cheng CH, et al. Evolution of microbiological trends and treatment outcomes in peritoneal dialysis-related peritonitis. Clin Nephrol, 2011, 75(5): 416-425.
11.	周詹兵, 石永兵, 沈华英, 等. 236 例次腹膜透析相关性腹膜炎的致病菌及耐药性分析. 中华肾脏病杂志, 2014, 30(3): 195-200.
12.	岳华, 纪小梅, 刘红, 等. 腹膜透析相关性腹膜炎的致病菌及药敏分析. 中华肾脏病杂志, 2012, 28(2): 149-150.
13.	冯敏, 郭群英, 余学清, 等. 提高腹膜透析相关感染性腹膜炎致病菌培养阳性率的方法学研究. 中华肾脏病杂志, 2007, 23(6): 345-349.
14.	Shigidi MM, Fituri OM, Chandy SK, et al. Microbial spectrum and outcome of peritoneal dialysis related peritonitis in Qatar. Saudi J Kidney Dis Transpl, 2010, 21(1): 168-173.
15.	吴晶晶, 刘佳, 张莉, 等. 腹膜透析相关性腹膜炎致病菌及耐药性分析. 中华医院感染学杂志, 2011, 21(16): 3521-3523.
16.	Wiggins KJ, Johnson DW, Craig JC, et al. Treatment of peritoneal dialysis-associated peritonitis: a systematic review of randomized controlled trials. Am J Kidney Dis, 2007, 50(6): 967-988.
17.	Miles R, Hawley CM, Mcdonald SP, et al. Predictors and outcomes of fungal peritonitis in peritoneal dialysis patients. Kidney Int, 2009, 76(6): 622-628.
18.	赵丽娟, 孙世仁, 杨君, 等. 腹膜透析相关性腹膜炎的致病菌及其易感因素分析. 中华肾病研究电子杂志, 2016, 5(3): 118-122.
19.	丁小容, 廖玉梅, 高敏, 等. 273 例次腹膜透析相关性腹膜炎临床特征分析. 护理学报, 2015, 22(23): 41-45.

1. Jain AK, Blake P, Cordy P, et al. Global trends in rates of peritoneal dialysis. J Am Soc Nephrol, 2012, 23(3): 533-544.
2. Verger C, Ryckelynck JP, Duman M, et al. French peritoneal dialysis registry (RDPLF): outline and main results. Kidney Int Suppl, 2006, 103(13): S12-S20.
3. Mujais S, Story K. Peritoneal dialysis in the US: evaluation of outcomes in contemporary cohorts. Kidney Int Suppl, 2006, 103(13): S21-S26.
4. Li PK, Szeto CC, Piraino B, et al. Peritoneal dialysis-related infections recommendations: 2010 update. Perit Dial Int, 2010, 30(4): 393-423.
5. 张明峰, 邱启泽, 李明宇, 等. 纸片扩散法与细菌鉴定系统的药敏结果比较. 中国医师杂志, 2011, 4(31): 123-124.
6. Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the United States. JAMA, 2007, 298(17): 2038-2047.
7. Muñoz De Bustillo E, Borrás F, Gómez-Roldán C, et al. Impact of peritonitis on long-term survival of peritoneal dialysis patients. Nefrologia, 2011, 31(6): 723-732.
8. Piraino B. Peritoneal dialysis infections recommendations. Contrib Nephrol, 2006, 150: 181-186.
9. Bulut C, Oztürk R, Yilmaz GR, et al. Evaluation of the epidemiological, clinical and laboratory findings in continuous ambulatory peritoneal dialysis related peritonitis attacks. Mikrobiyol Bul, 2008, 42(2): 255-264.
10. Huang ST, Chuang YW, Cheng CH, et al. Evolution of microbiological trends and treatment outcomes in peritoneal dialysis-related peritonitis. Clin Nephrol, 2011, 75(5): 416-425.
11. 周詹兵, 石永兵, 沈华英, 等. 236 例次腹膜透析相关性腹膜炎的致病菌及耐药性分析. 中华肾脏病杂志, 2014, 30(3): 195-200.
12. 岳华, 纪小梅, 刘红, 等. 腹膜透析相关性腹膜炎的致病菌及药敏分析. 中华肾脏病杂志, 2012, 28(2): 149-150.
13. 冯敏, 郭群英, 余学清, 等. 提高腹膜透析相关感染性腹膜炎致病菌培养阳性率的方法学研究. 中华肾脏病杂志, 2007, 23(6): 345-349.
14. Shigidi MM, Fituri OM, Chandy SK, et al. Microbial spectrum and outcome of peritoneal dialysis related peritonitis in Qatar. Saudi J Kidney Dis Transpl, 2010, 21(1): 168-173.
15. 吴晶晶, 刘佳, 张莉, 等. 腹膜透析相关性腹膜炎致病菌及耐药性分析. 中华医院感染学杂志, 2011, 21(16): 3521-3523.
16. Wiggins KJ, Johnson DW, Craig JC, et al. Treatment of peritoneal dialysis-associated peritonitis: a systematic review of randomized controlled trials. Am J Kidney Dis, 2007, 50(6): 967-988.
17. Miles R, Hawley CM, Mcdonald SP, et al. Predictors and outcomes of fungal peritonitis in peritoneal dialysis patients. Kidney Int, 2009, 76(6): 622-628.
18. 赵丽娟, 孙世仁, 杨君, 等. 腹膜透析相关性腹膜炎的致病菌及其易感因素分析. 中华肾病研究电子杂志, 2016, 5(3): 118-122.
19. 丁小容, 廖玉梅, 高敏, 等. 273 例次腹膜透析相关性腹膜炎临床特征分析. 护理学报, 2015, 22(23): 41-45.

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