Clinical pathogenic characteristics of peritoneal dialysis-associated peritonitis and rational use evaluation of antibiotics in a hospital

Deng Yimai; Chen Ruihuan

doi:10.3969/j.issn.1674-7151.2025.01.004

Abstract：Objective To analyze the clinical pathogenic characteristics of peritoneal dialysis-associated peritonitis(PDAP)in a municipal hospital in Changshu,Jiangsu Province,evaluate the rationality of antibiotic selection,and provide basis for clinical rational drug use.Methods Clinical data of 46 PDAP patients admitted in Changshu Hospital Affiliated to Soochow University from 2018 to 2023 were collected and reviewed,including clinical signs,laboratory indicators,pathogenic bacteria distribution,drug sensitivity and anti-infective treatment.Results The 46 patients experienced 56 cases of PDAP,and the clinical manifestations were abdominal pain,cloudy peritoneal fluid and fever.The 43 strains of pathogenic bacteria were isolated and cultured,including 33 strains(76.74%)of Gram positive(G+)bacteria,mainly Staphylococcus genus,and 10 strains(23.26%)of Gram negative(G-)bacteria.The sensitivity of G+bacteria to benzylpenicillin was 38.10%,while those of G-bacteria to ceftriaxone,ceftazidime and amikacin were 62.50%,90.00%and 100.00%.The rational rate of antibiotic treatment was 66.07%,and 19 cases(33.93%)had inappropriate selection of antibiotic varieties for initial or subsequent treatment,of which 10 cases(17.86%)only had unreasonable initial treatment,2 cases(3.57%)only had unreasonable subsequent treatment,and 7 cases(12.50%)had unreasonable initial and subsequent treatment.Conclusions The main pathogenic bacteria for PDAP are G+bacteria.The initial treatment recommendation is to cover G+bacteria with vancomycin and G-bacteria with cefotaxime or amikacin.Subsequent treatment should be based on factors such as drug sensitivity,bacterial resistance mechanisms and initial treatment outcomes,and the antibiotics should be rationally selected.