Pathogenic bacteria and drug resistance in peritoneal dialysis related peritonitis

Abstract

To investigate the pathogens and their resistance in continuous ambulatory peritoneal dialysis (CAPD) related peritonitis. A total of 78 cases with CAPD related peritonitis from Xiangya Hospital between January 2007 and January 2011 were reviewed. Pathogens, resistance and outcomes of the 78 cases CAPD related peritonitis were analyzed retrospectively. Among them, 53 cases cultured positive (66.67%), 3 of which were combined infection and 2 strains were cultured. A total of 55 strains were cultured, including 32 gram-positive strains (58.18%), 18 gram-negative strains (32.72%) and 5 fungi (9.09%). The most common pathogens were coagulase negative staphylococcus, staphylococcus aureus and Escherichia coli. Drug sensitivity test of the gram-positive strains showed that the three with lowest antibiotic resistance were linezolid (0), teicoplanin (3.13%) and vancomycin (4.0%). Drug sensitivity test of the gram-negative bacteria showed that antibiotics with the lowest resistance were amikacin and imipenem, followed by piperacillin/tazobactam and cepoperazon/sulbactam. Cephazolin had the highest resistance rate of 83.33%. Clinical outcomes: 63 cases cured (80.77%); 11 cases transferred to hemodialysis (14.1%); 4 cases died (5.13%), including 2 cases fungus infections, 1 gram-negative bacteria infection and 1 combined infection. The most common pathogens causing peritoneal dialysis associated peritonitis is gram positive bacteria. In the empirical treatment, in addition to traditional treatment of Cefazolin combined with aminoglycosides, cefazolin combined with piperacillin/tazobactam or cepoperazon/sulbactam is preferable for CAPD associated peritonitis.