标题:
Clinical characteristics and risk factors associated with Enterbacteriaceae peritonitis among patients on peritoneal dialysis
讲者:
吴海珊
单位:
中山大学附属第一医院
播放:
1625
论文摘要:
Objective Enterobacteriaceae peritonitis is a serious complication, but the clinical course of Enterobacteriaceae
peritonitis remains unclear. The objective of the study was to analyze characteristics, risk factors and outcomes of Enterobacteriaceae peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
Methods In this retrospective observational cohort study, all incident PD patients in our PD center from Jan 1, 2006 to Dec 31, 2013 were recruited and followed up until Dec 31, 2014. Risk factors associated with the first episode of peritonitis caused by Enterobacteriaceae were evaluated using Cox proportional model.
Results In a cumulative 61355.8 patients-months follow-up of 1690 CAPD patients, 807 episodes of peritonitis occurred in 503 (29.8%) patients, 203 (24.4%) of which were caused by Enterobacteriaceae. And 110 patients presented Enterobacteriaceae peritonitis for the first time, and the most common species was Escherichia, accounting for 65 episodes. The multivariate analysis showed that factors associated with risk for the first episode of Enterobateriaceae peritonitis were diabetes mellitus (HR 2.40, 95%CI: 1.20-4.82, p=0.014) and low education level (HR1.63, 95%CI: 1.01-2.65, p=0.043). The complete cure rate of Enterobateriaceae peritonitis were 90.9%,and no significant difference compared with non-Enterobateriaceae peritonitis (88.3%, p=0.872). Of the 110 episodes of peritonitis caused by enterobateriaceae, 6 (5.5%) developed relapsing peritonitis, 4 (3.6%) developed recurrent peritonitis and 10 (9.1%) developed repeated peritonitis, higher than those caused by other pathogens, accounting for 8 (2.0%), 15 (3.8%) and 8(2.0%) episodes, respectively (p=0.005). Furthermore, Enterobateriaceae peritonitis was found to be increased risk for relapsing or repeated peritonitis (OR 4.02, 95%CI 1.94-8.34, p=0.018).
Conclusions Diabetes and low education level are risk factors associated with Enterobateriaceae peritonitis. More relapsing or repeated peritonitis happened in patients with Enterobateriaceae peritonitis.