Clinical characters of peritoneal dialysis-related staphylococcus peritonitis / 中华肾脏病杂志

ABSTRACT

Objective To provide evidence for clinical diagnosis and treatment of staphylococcus peritonitis through retrospective analysis of peritoneal dialysis related clinical characters. Methods Patients who experienced staphylococcus peritonitis were observed as peritonitis group.Patients did not experience peritonitis were observed as one-to-one control group in order to investigate predictors of staphylococcus peritonitis,bacteria spectrum,antimicrobial resistance and clinical outcomes. Results There were 74 patients enrolled in either group.For patients in peritonitis group,Kt/V(1.74±0.03 vs 2.61±0.48,P＜0.01),CrCL[(55.82±2.22) ml/min vs (76.13±17.42) ml/min,P＜0.01],GFR [(1.32±0.55) ml/min vs (3.08±0.75) ml/min,P＜0.01],nutrition index,hemoglobin[(91.70±25.43) g/L vs (111.50±19.59) g/L,P＜0.01],potassium[(3.43±0.70) mmol/L vs (3.78±0.73) mmol/L,P=0.002],sodium [(137.09±5.06) mmol/L vs (140.57±3.55)mmol/L,P＜0.01],chloride [(98.31±6.14) mmol/L vs (101.52±4.58) mmol/L,P=0.001] and calcium [(2.23±0.24) mmol/L vs (2.31±0.22) mmol/L,P=0.04] in serum were significantly lower than those in control group.The morbidity of staphylococcus peritonitis was 0.030 episode per year in recent five yearn.The major strains were Staphylococcus epidermidis,followed by Staphylococcus aureus.Staphylococci were all sensitive to vancomycin,teicoplanin and linezolid.The cure rate was 89.19％,and mortality was 4.05％.Relapse rate of Staphylococcus epidermidis peritonitis was higher (40％) than other strains. Conclusions Poor nutrition,insufficient dialysis,longer followup interval,anemia,electrolytic imbalance are the risk factors of Staphylococcus peritonitis.The morbidity and mortality are lower than before.Staphylococcus epidermidis peritonitis has higher relapse rate and requires more attention to prevention and treatment.