Clinical Outcome and Risk Factors of Treatment Failure of Peritoneal Dialysis Associated Peritonitis Caused by Klebsiella Pneumoniae:A Multicenter Study.
10.3881/j.issn.1000-503X.15138
- Author:
Hui-Zhi YUAN
1
;
Xue-Yan ZHU
2
;
Li-Ming YANG
3
;
Xiao-Xuan ZHANG
4
;
Xin-Yang LI
1
;
Tong XIE
1
;
Jing-Zhu ZHAI
1
;
Xiao-Hua ZHUANG
1
;
Wen-Peng CUI
1
Author Information
1. Department of Nephrology,the Second Hospital of Jilin University,Changchun 130041,China.
2. Department of Nephrology,Jilin Central Hospital,Jilin,Jilin 132011,China.
3. Department of Nephrology,the Second Branch of the First Hospital of Jilin University,Changchun 130031,China.
4. Department of Nephrology,Jilin First Automobile Work General Hospital,Changchun 130011,China.
- Publication Type:Journal Article
- Keywords:
peritoneal dialysis;
peritonitis
- MeSH:
Humans;
Klebsiella pneumoniae;
Retrospective Studies;
Anti-Bacterial Agents/therapeutic use*;
Peritoneal Dialysis/adverse effects*;
Peritonitis/drug therapy*;
Risk Factors;
Treatment Failure;
Escherichia coli
- From:
Acta Academiae Medicinae Sinicae
2023;45(2):227-234
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the treatment outcomes,prognosis,and risk factors of treatment failure of peritoneal dialysis associated peritonitis (PDAP) caused by Klebsiella pneumoniae,and thus provide clinical evidence for the prevention and treatment of this disease. Methods The clinical data of PDAP patients at four peritoneal dialysis centers from January 1,2014 to December 31,2019 were collected retrospectively.The treatment outcomes and prognosis were compared between the patients with PDAP caused by Klebsiella.pneumoniae and that caused by Escherichia coli.Kaplan-Meier method was employed to establish the survival curve of technical failure,and multivariate Logistic regression to analyze the risk factors of the treatment failure of PADP caused by Klebsiella pneumoniae. Results In the 4 peritoneal dialysis centers,1034 cases of PDAP occurred in 586 patients from 2014 to 2019,including 21 cases caused by Klebsiella pneumoniae and 98 cases caused by Escherichia coli.The incidence of Klebsiella pneumoniae caused PDAP was 0.0048 times per patient per year on average,ranging from 0.0024 to 0.0124 times per patient per year during 2014-2019.According to the Kaplan-Meier survival curve,the technical failure rate of Klebsiella pneumoniae caused PDAP was higher than that of Escherichia coli caused PDAP (P=0.022).The multivariate Logistic regression model showed that long-term dialysis was an independent risk factor for the treatment failure of Klebsiella pneumoniae caused PDAP (OR=1.082,95%CI=1.011-1.158,P=0.023).Klebsiella pneumoniae was highly sensitive to amikacin,meropenem,imipenem,piperacillin,and cefotetan,and it was highly resistant to ampicillin (81.82%),cefazolin (53.33%),tetracycline (50.00%),cefotaxime (43.75%),and chloramphenicol (42.86%). Conclusion The PDAP caused by Klebsiella pneumoniae had worse prognosis than that caused by Escherichia coli,and long-term dialysis was an independent risk factor for the treatment failure of Klebsiella pneumoniae caused PDAP.
