Peritonitis Due to Stenotrophomonas Maltophilia in Patients Undergoing Chronic Peritoneal Dialysis
Peritonitis Due to Stenotrophomonas Maltophilia in Patients Undergoing Chronic Peritoneal Dialysis
复制标题
慢性腹膜透析患者嗜麦芽窄食单胞菌引起的腹膜炎
DOI：
10.1177/089686089901900312
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发表时间：
1999
影响因子：
2.8
通讯作者：
M. Dasgupta
中科院分区：
文献类型：
--
作者：
G. Taylor;M. McKenzie;M. Buchanan;Daisy Perry;L. Chui;M. Dasgupta
在慢性腹膜透析（PD）患者中发生嗜麦芽窄食单胞菌性腹膜炎病例，促使我们对这种情况的经验进行回顾。对微生物学记录的搜索发现了七次S。1996年7例患者发生嗜麦芽窄食单胞菌腹膜炎-占所有PD患者的3.8%-而1994年和1995年无病例（p = 0.01）。患者年龄范围为16 - 64岁; 3名男性和4名女性。7例腹膜炎中有6例为社区获得性，1例为医院获得性。未观察到病例的时间聚集。患者来自不同的城乡社区。患者使用相同的市售透析液、不同的透析技术，并学习了非接触式连接技术。腹膜炎的治疗需要在7例病例中的4例中取出Replikhoff导管。使用源自16/23 Sr RNA基因序列保守区的引物通过聚合酶链反应和脉冲场凝胶电泳对六个可用分离株进行指纹图谱分析，结果显示所有分离株都是独特的菌株。本研究采用病例对照研究方法，比较了7种S。嗜麦芽窄食单胞菌病例与21例PD对照的比较显示，病例患者更年轻，更可能接受免疫抑制治疗。我们的结论是S.嗜麦芽窄食单胞菌已成为腹膜炎的一个重要原因，在我们的持续性非卧床腹膜透析人群。迄今为止的证据表明，社区收购没有共同来源的证据。
The occurrence of cases of Stenotrophomonas maltophilia peritonitis in chronic peritoneal dialysis (PD) patients prompted a review of our experience with this condition. A search of microbiology records revealed seven episodes of S. maltophilia peritonitis in 7 patients in 1996 — 3.8% of all PD patients — compared to no cases in 1994 and 1995 (p = 0.01). Patients ranged in age from 16 to 64 years; there were 3 males and 4 females. Six of seven episodes of peritonitis were community acquired and one was hospital acquired. No temporal clustering of cases was seen. Patients were from different urban and rural communities. Patients used the same commercially supplied dialysate fluid, different dialysis techniques, and were taught a no-touch technique for connection. Treatment of peritonitis required removal of the Tenckhoff catheter in 4 of 7 cases. Fingerprinting of six available isolates by polymerase chain reaction using primers derived from the conserved region of the 16/23Sr RNA gene sequence and pulsed field gel electrophoresis revealed all to be unique strains. A case-control study comparing 7 S. maltophilia cases to 21 PD controls showed case patients to be younger and more likely to be on immuno-suppressive therapy. We conclude that S. maltophilia has emerged as an important cause of peritonitis in our continuous ambulatory PD population. Evidence to date suggests community acquisition with no evidence of a common source.