Pathogenic bacteria,antibiotic resistance and prognosis of peritonitis in peritoneal dialysis patients

Objective To investigate the pathogenic bacteria, antibiotic resistance and prognosis of peritonitis in peritoneal dialysis (PD) patients.Methods 318 patients with peritonitis from January 2009 to September 2016 were enrolled in this study. Pathogenic bacteria culture and drug sensitivity test of PD fluids were performance. The distribution of pathogenic bacteria and their resistance to antibiotics, and clinical outcomes of peritonitis were analyzed.Results (1)Distribution of pathogenic bacteria:185 cases were positively cultured in PD fluids(58.1%), resulting in a total of 194 strains of microorganisms, including 131 Gram-positive strains (67.5%), 49 Gram-negative strains (25.2%) and 14 fungi strains (7.2%). Among Gram-positive strains, staphylococcus epidermidis and staphylococcus aureus were common pathogens, accounting for 25.9% and 10.6% respectively. Among Gram-negative strains, colibacillus was major pathogens, accounting for 40.8%. (2)The resistance to antibiotics of pathogenic bacteria:Drug sensitivity test showed Gram-positive strains had highest resistance against penicillin. Gram-negative strains had the highest resistance against ampicillin but the lowest resistance against piperacillin-tazobactam and cefoperazone-sulbactam. Fungi were sensitive to normal antifungal agents. (3)Prognosis of peritonitis:267 cases/times were cured (83.9%), 51 cases dropped out of PD (16.0%), 31 cases were subjected to the removal of catheter and transferred to hemodialysis (9.7%), 13 cases were died (4.0%), and 7 cases lost to follow-up. (4)Analysis of pathogenic bacteria for relapsing, recurrence and repeat peritonitis:There were 2 cases of staphylococcus lugdunensis infection, 1 case of staphylococcus epidermidis infection among 3 cases of relapsing peritonitis (0.94%). Moreover, 1 case of recurrence peritonitis (0.31%) and 2 cases of repeat peritonitis (0.62%) were observed.Conclusions Gram-positive bacteria are major pathogenic bacteria in peritonitis patients in our center. Both Gram-positive and Gram-negative bacteria are high resistant to non-enzyme antibiotics. Sensitive antimicrobial therapy is the key to successfully treat peritonitis.