ABSTRACT
Objective To investigate the relationship between serum 25-hydroxycholecalciferol [25(OH)D3] deficiency and the risk of peritoneal dialysis associated peritonitis.Methods Baseline clinical data (before the peritoneal dialysis catheter insertion) of peritoneal dialysis patients treated with CAPD in the First Affiliated Hospital of Guangxi Medical University from May 1,2013 to February 1,2016 were retrospective analyzed.All the patients were followed-up until July 31,2016.According to the baseline serum 25(OH)D3 levels,patients were divided into deficiency group (25(OH)D3 ＜ 15 ng/ml) and non deficiency group (25(OH)D3 ≥ 15 ng/ml),the baseline clinical data of the two groups were also analyzed.Kaplan-Meier method was used to compare the time-to-peritonitis of two groups.Cox proportional hazard model was used to analyze the relationship between the 25(OH)D3 deficiency and the risk of peritonitis.ROC curve was used to analyze the predictive value of the baseline serum 25(OH)D3 for the risk of PDAP in peritoneal dialysis patients.Results Compared with the 25(OH)D3 non deficiency group,25(OH)D3 deficiency group had a significant increase incidence of peritonitis,high diastolic blood pressure and mean arterial pressure,but serum albumin,total serum protein decreased significantly (P ＜ 0.05).Kaplan-Meier survival analysis showed that,compared with 25(OH)D3 non deficiency group,the time-to-peritonitis episode of patients with 25(OH)D3 deficiency were shorter (P ＜ 0.05).Cox proportional hazard model showed that after adjusting for age,sex,hemoglobin,serum albumin,C-reactive protein,total Kt/V,eGFR,diabetes or not,25(OH)D3 deficiency is the independent risk factor of peritoneal dialysis associated peritonitis (HR 5.247,95％CI 1.180-23.340,P ＜ 0.05).ROC curve showed the area under the curve that baseline serum 25(OH)D3 deficiency predict the occurrence of PDAP was 0.714,and the best cut-off point of baseline serum 25(OH)D3 was 11.35 ng/ml (sensitivity 75％,specificity 63％).Conclusions Peritoneal dialysis associated peritonitis occurred earlier in peritoneal dialysis patients whose baseline serum 25(OH)D3 deficiency.Baseline serum 25(OH)D3 deficiency is the independent risk factor of peritoneal dialysis associated peritonitis,which may predict the incidence of peritoneal dialysis associated peritonitis.
ABSTRACT
Objective To investigate the prevalence of aminoglycoside resistance gene in multidrug-resistant Acinetobacter bau-mannii isolated in clinical at a certain time,and to provide the basis for the control of nosocomial infection.Methods 9 strains of multidrug-resistant Acinetobacter baumannii were isolated in First People′Hospital of Weifang from November 26,2013 to Decem-ber 12,2013.Identification of bacteria and susceptibility testing were conducted by VITEK2,and partial antimicrobial drug suscepti-bility tests were performed by the disk diffusion method.Aminoglycoside resistance genes were detected by PCR and the positive genes were partly sequenced.Results Among the 9 stains of multidrug-resistant Acinetobacter baumannii,2 strains carried aac(3)-Ⅰ gene,3 carried ant(3″)-Ⅰ gene,3 carried aac(6′)-Ⅰ gene.AndarmA gene was positive in 9 strains.All strains were resistant to aminoglycosides,such as amikacin,gentamicin and tobramycin.There were 5 specien issolated in ICU,while 3 specimens were isola-ted in neurosurgery ward.All specimens were separated from sputum.Conclusion Antimicrobial resistance to aminoglycosides of Acinetobacter baumannii isolated in the hospital during this time was related to aminoglycoside resistance gene.Nosocomial infec-tion caused by multidrug-resistant Acinetobacter baumanniiin,ICU and neurosurgery ward should be vigorously monitored.