Risk factors and clinical outcomes of multidrug-resistant bacteria infection in peritoneal dialysis associated peritonitis patients
10.19405/j.cnki.issn1000-1492.2023.06.025
- Author:
Hui Li
1
;
Yuanyuan Li
1
;
Pei Zhang
1
;
Yonggui Wu
1
Author Information
1. Dept of Nephropathy，The First Affiliated Hospital of Anhui Medical University，Hefei 230022
- Publication Type:Journal Article
- Keywords:
peritoneal dialysis-associated peritonitis;
multidrug-resistant;
refractory peritonitis
- From:
Acta Universitatis Medicinalis Anhui
2023;58(6):1025-1029
- CountryChina
- Language:Chinese
-
Abstract:
Objective : This study aimed to assess the incidence ，etiological characteristic ，potential risk factors and clinical outcomes of multidrug-resistant (MDR) infection in patients with peritoneal dialysis associated peritoni- tis (PDAP) ．
Methods : The data of PDAP patients admitted in recent 3 years in our center were collected retro- spectively to analyze the distribution of pathogenic bacteria and drug resistance．According to whether the pathogen- ic bacteria were MDR or not，they were divided into MDR group and non-MDR group．The data of the two groups were compared，and the risk factors and clinical outcomes of MDR infection were analyzed.
Results :PDAP pa- tients were mainly infected with gram-positive bacteria． Staphylococcus was the most common pathogen isolated from the peritoneal fluid in the MDR group，accounting for 60. 6% (43 /71) ，and streptococcus was the most com- mon pathogen isolated in the non-MDR group，accounting for 42. 0% (21 /50) ．Multivariate analysis showed that the use of wide-spectrum antibiotics for more than 5 days within 3 months before the onset of PDAP ( OR = 3. 634， P = 0. 033) ，gram-positive bacterial infection ( OR = 3. 741，P = 0. 031 ) ，higher lipoprotein ( a) level ( OR = 1. 003，P = 0. 003) ，and higher platelet-to-albumin ratio ( OR = 1. 198，P = 0. 038) were independent risk factors for MDR infection in PDAP patients．The incidence of refractory peritonitis in MDR group (29. 6% ) was higher than that in non-MDR group ( 12. 0% ) ( χ2 = 5. 229 ，P = 0. 022 ) ． The incidence of recurrent peritonitis ( 16. 9% ) was also higher than that in the non-MDR group (4. 0% ) ( χ2 = 4. 773，P = 0. 029) ．
Conclusion : The main pathogen of MDR infection is staphylococcus in PDAP patients． Compared with the non-MDR group ，the MDR group has a higher proportion of wide-spectrum antibiotics used for more than 5 days within 3 months before the onset of PDAP，a higher proportion of gram-positive bacterial infection，higher lipoprotein ( a) level，higher platelet-to-albumin ratio，and an increased risk of refractory peritonitis and recurrent peritonitis.
- Full text:2024101509564005642腹膜透析相关性腹膜炎患者发...菌感染的危险因素与临床结局_李慧.pdf
