Analysis of microbial spectrum and antibiotic resistance in 129 cases patients of peritoneal dialysis related peritonitis

Objective Peritoneal dialysis related peritonitis is still an important cause of failure of peritoneal dialysis and death. To investigate the microbial spectrum and antibiotic resistance of continuous ambulatory peritoneal dialysis (CAPD) related peritonitis and guide the clinical rational use of antimicrobial agents. Methods A retrospective analysis was made of CAPD related peritonitis in 129 cases with peritoneal dialysis culture results in the Shaoxing People's Hospital from January 1, 2012 to December 31, 2016. Distribution of pathogenic bacteria and its resistance to common antibiotics were analyzed. Results In 129 cases of CAPD related peritonitis, peritoneal fluid culture was positive in 97 cases, the positive rate was 75.19%. A total of 98 strains of bacteria were isolated, gram positive bacteria infection (G⁺) in 69 cases (71.14%), gram negative bacteria infection (G^-) in 26 cases (26.80%), including 1 cases of Escherichia coli and Klebsiella pneumoniae infection, fungal infection in 2 cases (2.06%). Drug sensitivity test of Staphylococcus aureus was sensitive to vancomycin, tigecycline and linezolid, teicoplanin on a case of intermediary and drug resistance. Streptococcus were sensitive to vancomycin, chloramphenicol, vancomycin and Enterococcus were sensitive to tigecycline; G^- bacteria were sensitive to imipenem,meropenem and ertapenem. One hundred and twenty-nine cases of patients with a total of 1 cases of death, 2 cases give up the treatment, and 5 cases transferred to hemodialysis. Conclusion The main pathogen of CAPD related peritonitis is Gram-positive bacteria. Cefazoline combined with piperacillin/tazobartan, cefoperazone/Shubatan or butanamycin are recommended as empirical drugs for the treatment of peritonitis. Direct vancomycin plus cefoperazone/sulbactam may be considered for severe infection.