title: [Clinical analysis for patients with continuous ambulatory peritoneal dialysis associated peritonitis].
abstract: To analyze the clinical characteristics of continuous ambulatory peritoneal dialysis (CAPD) associated peritonitis in the tertiary hospitals and to discuss the preventive and therapeutic strategy.  Methods: The clinical characteristics, pathogens, resistance and outcomes of 126 CAPD associated peritonitis in 104 patients from Jan, 2013 to June, 2016, were retrospectively analyzed.  Results: Among the patients, the incidence rates of abdominal pain, fever, diarrhea and emesis were 104 (82.54%), 56 (44.44%), 49 (38.89%), and 31 (23.60%), respectively. Among them, 88 patients suffered peritonitis once, other 16 patients suffered multiple peritonitis or recurrent peritonitis for 38 times. Among the 38 times, the numbers for recurrent, repeated or catheter-associated peritonitis were 2, 2, or 3, respectively. Peritoneal fluids from 103 cases were cultured, and 64 cases were positive in bacteria, with a rate of 62.14%. A total of 70 strains of bacteria were separated, including 42 strains of gram-positive bacteria, 21 strains of gram-negative bacteria, and 7 strains of fungus. The most common gram-positive pathogens were Staphylococcus epidermidis, Enterococcus faecalis and Staphylococcus haemolyticus, while Escherichia coli, Klebsiella pneumoniae and Klebsiella pneumoniae were the most common gram-negative bacteria. Candida albicans was the major fungal pathogens. Gram-positive cocci showed resistance to gentamycin, levofloxacin, moxifloxacin, vancomycin and linezolid, with a rate at 20.00%, 36.11%, 5%, 0%, and 0%, respectively. The gram-negative bacilli were resistent to cefoperazone/sulbactam, gentamycin, cephazolin, and ceftazidime, with a rate at 6.25%, 10.53%, 64.29%, and 15.38%, respectively. There were no imipenem, amikacin, piperacillin/tazobactam-resistant strains were found.  Conclusion: The most common pathogen causing CAPD associated peritonitis is gram-positive bacteria. It is crucial to take the anti-infection therapy for CAPD associated peritonitis early. The positive rates for bacterial culture need to be enhanced through improvement of methods. At the same time, doctors could improve the outcome of CAPD associated peritonitis by adjusting the medication according to the drug sensitivity results.
authors.affiliation: .Department of Infection Control, Dunhuan Municipal Hospity, Dunhuang Gansu 736200, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Infection Control, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Xun
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Infection Control, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Nephrology, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Infection Control, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Rui'e
authors.initials: R
authors.lastname: Gong
authors.affiliation: Department of Infection Control, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Chunhui
authors.initials: C
authors.lastname: Li
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology; D000900:Anti-Bacterial Agents; D001419:Bacteria; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D002177:Candidiasis / Q000453:epidemiology; D057785:Catheters / Q000009:adverse effects / Q000382:microbiology; D003967:Diarrhea / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D013293:Enterococcus faecalis; D004926:Escherichia coli; D005334:Fever / Q000453:epidemiology; D006090:Gram-Negative Bacteria; D006094:Gram-Positive Bacteria; D006801:Humans; D015378:Imipenem; D007711:Klebsiella pneumoniae; D008826:Microbial Sensitivity Tests; D009181:Mycoses / Q000453:epidemiology; D010397:Penicillanic Acid / Q000031:analogs & derivatives; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology*; D010878:Piperacillin; D000077725:Piperacillin, Tazobactam Drug Combination; D012008:Recurrence; D012189:Retrospective Studies; D013212:Staphylococcus epidermidis; D041162:Staphylococcus haemolyticus; D014839:Vomiting / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D015378:Imipenem; D010397:Penicillanic Acid; D010878:Piperacillin