Outcome Following CAPD Associated Gram-Negative Peritonitis

腹膜透析併發格蘭氏陰性菌腹膜炎之預後分析

陳嘉聖(C. S. Chen) ； 鍾錫裕(S. Y. Chung) ； 賴銘南(M. N. Lai) ； 周銘源(M. Y. Chou) ； 鄭裕文(Y. W. Cheng) ； 許逸生(I. S. Hsu) ； 高銘聰(M. T. Kao)

《Acta Nephrologica》 14卷4期 (2000/10) Pp. 323-323

並列摘要

* Background: peritonitis remains the leading cause of patient dropout from peritoneal dialysis therapy. Gram-positive (G(+)) bacteria predominate as the causative pathogen of continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis. However, gram-negative (G(-)) peritonitis had poor outcome. Few studies have compared the outcome for patients undergoing CAPD who developed ifferent kinds of G(-) peritonitis. This study evaluated the difference in morbidity, mortality and outcome between peritonitis caused by E. coli, Klebsiella pneumonia, Pseudomonas aeruginosa, and Enterobacter spp.
* Methods: A single regional dialysis dialysis unit in a medical center with prospective observational study was designed. 120 patients, 220 episodes, 45 episodes of G(-) peritonitis between January 1998 and November 2000. Survival analysis was performed for time to (1) death, (2) removal of peritoneal dialysis catheter, and (3) change to hemodialysis. Basic data, hospital admission. Basic data, hospital admission, laboratory values, infection type (new onset, re-infection, recurrent) and the route of antibiotics (IV of IP) were also recorded and analyzed.
* Result: There was no difference in age, sex, DM, hospital admission, positive rate of blood culture, infection type and the route of antibiotics between the four groups. The only different value-serum albumin was higher in E.coli group than the others (p＜0.05). No difference in time to death, removal of peritoneal dialysis catheter, and change to hemodialysis were demonstrated for the four group (p=0.48)
* Conclusion: We conclude that the outcome between peritonitis caused by E.coli, Klebsiella pneumonia, Pseudomonas aeruginosa, and Enterobacter spp. are not different. However, we should keep our observation and might increase our sample size to confirm this result.