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Objective To investigate the pathogens and their antibiotic resistance in patients with peritoneal dialysis‐related peritonitis .Methods The clinical data including pathogens ,antibiotic resistance profile of 213 patients with peritoneal dialysis‐related peritonitis who were treated in our peritoneal dialysis center from January 2011 to December 2013 were analyzed retrospectively .Results Dialysate culture was positive for 132 (62 .0% ) of the 213 cases ,resulting in a total of 140 strains of microorganisms ,including 84 strains of gram positive cocci ,37 strains of gram‐negative bacilli ,10 strains of fungus and 9 strains of gram positive bacilli . Coagulase‐negative Staphylococcus was the most common gram positive bacteria while Escherichia coli was the most common gram negative bacteria isolated from the effluent .The prevalence of methicillin‐resistant S .aureus and methicillin‐resistant coagulase negative Staphylococcus was 14 .3% (1/7) and 43 .2% (19/44) ,respectively . About 44 .4% (8/18) of the E .coli and K . pneumoniae isolates produced extended spectrum beta‐lactamases .All the gram‐positive cocci were sensitive to vancomycin and linezolid and slightly resistant to chloramphenicol (6 .3% ) , moxifloxacin (8 .5% ) , and rifampicin (9 .5% ) , but highly resistant to cefazolin (90 .0% ) ,followed by ampicillin (76 .7% ) ,oxacillin (71 .2% ) and penicillin (69 .7% ) . Coagulase negative Staphylococcus isolates were sensitive to vancomycin , linezolid , tigecycline , quinupristin‐dalfopristin and daptomycin ,but all resistant to cefazolin and ampicillin ,and highly resistant to penicillin (91 .9% ) and oxacillin (82 .5% ) .All the gram‐negative bacilli were sensitive to meropenem ,ertapenem ,cefoperazone‐sulbactam and tigecycline .About 80 .6% and 65 .5% of the gram‐negative bacilli were resistant to ampicillin and peperacillin ,respectively .E .coli isolates were sensitive to meropenem ,ertapenem and piperacillin‐tazobactam but highly resistant to ampicillin (81 .3% ) and piperacillin (71 .4% ) . Conclusions Gram‐positive cocci especially Staphylococcus and gram negative bacteria E .coli are major pathogens in peritoneal dialysis‐related peritonitis .Adequate microbiological culture and suitable antimicrobial therapy are key to successful treatment of the peritonitis associated with peritoneal dialysis .
ABSTRACT
The heparan sulfate proteoglycan(HSPG) is the major part of sulfated macromolecules synthesized by the cultured rat GECs, and plays an important role in maintaining the glomerular charge—selective function. We have investigated the effects of lipopolysaccharide (LPS, 6.25ng/ml), human recombinant interleukin—2, (HrI1—2, 2. 5u/ml), and protamine sulfate(PtS, 100?g/ml) on the proliferation of rat GEC and incorporation of 35 SO into cell layers in vitro. A method of 3 H—TdR and 35 S—Na_2SO_4 dual isotope labelling technique was used. Statistical analysis was done using analysis of variance for both 3 H—TdR uptake and 35 SO incorporation, and analysis of variance only for the latter. These results show that LPS, HrIL—2 and PtS inhibited the proliferation of rat GECs. HrIL—2 also directly inhibited the incorporation of 35 SO into cell layers, but the roles of LPS and PtS, which decreased 35 SO—content, only came from their inhibition effects on cell proliferation. We suppose that the decreased production of HSPG by GECs, may contribute to the development of proteinuria.
ABSTRACT
AIM: To investigate the effects and mechanism of enalapril on nephritis of diabetic mice. METHODS: Diabetes was induced by injection of streptozotocin after uninephrectomy. Rats were randomly divided into three groups: control, diabetes, diabetes treated with enalapril (10 mg?kg~-1 ?d~-1 by gavage). 8 weeks after STZ injection, urine albumin excretion rate (AER) were measured, and glomerular morphology were observed by light microscopy. The levels of malonyldialdehyde (MDA) in renal tissue and urine as well as activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX) in renal tissue were determined. Immunohistochemistry for ED-1 (macrophage marker), monocyte chemoattractant protein-1 (MCP-1) and intercellular adhesion molecule-1 (ICAM-1) were performed by streptavidin-biotin complex (SABC) technique. RESULTS: Increased kidney weight, ratio of kidney weight to body weight, AER and expansion of mesangial as well as tuft areas on histological examination of the kidney were significantly attenuated by the treatment of enalapril (P