PDF(Pubmed)
Abstract：
Background This study aims to contribute to peritonitis management strategies by comparing the demographic, clinical, and laboratory characteristics of patients diagnosed with spontaneous bacterial peritonitis (SBP), peritoneal dialysis-related peritonitis (PDrP), and secondary peritonitis. Methods This study included 86 patients diagnosed with peritonitis between 2016 and 2022. Patients were categorized and compared as SBP, PDrP, and secondary peritonitis. Results SBP was diagnosed in 36% of patients, secondary peritonitis in 36% and PDrP in 28%. The mean age of patients with PDrP is 43.71 ± 14.74, which is significantly lower compared to those with SBP and secondary peritonitis (p<0.001). Patients with hypertension (HT), chronic kidney disease (CKD), and those undergoing dialysis most commonly have PDrP whereas those without HT, without CKD, and not undergoing dialysis are most often diagnosed with secondary peritonitis (p=0.002, p<0.001, p<0.001). In peritoneal fluid cultures, the growth of Gram-positive bacteria was most commonly identified in patients with PDrP, while the growth of Gram-negative bacteria was most frequently seen in patients with secondary peritonitis (p=0.018). CRP levels and sedimentation rates were found to be higher in patients with secondary peritonitis (p<0.001, p=0.003). Conclusion The distinct characteristics observed across different types of peritonitis underscore the importance of tailored approaches to diagnosis and treatment. Parameters such as CRP levels, sedimentation rates, and patient age could serve as valuable indicators in discerning between various types of peritonitis. When selecting empirical antibiotic therapy, it\'s crucial to consider coverage for Gram-positive pathogens in cases of PDrP and Gram-negative pathogens in secondary peritonitis.
摘要：
背景本研究旨在通过比较人口统计学，为腹膜炎的管理策略做出贡献。临床,诊断为自发性细菌性腹膜炎（SBP）的患者的实验室特征，腹膜透析相关性腹膜炎（PDrP），和继发性腹膜炎。方法本研究纳入2016年至2022年诊断为腹膜炎的86例患者。将患者分类并比较为SBP，PDrP,和继发性腹膜炎。结果36%的患者诊断出SBP,36％的继发性腹膜炎和28％的PDrP。PDrP患者的平均年龄为43.71±14.74，与SBP和继发性腹膜炎患者相比明显更低（p<0.001）。高血压（HT）患者，慢性肾脏病（CKD），那些接受透析的人最常见的是PDrP，而那些没有HT的人，没有CKD,未进行透析最常诊断为继发性腹膜炎（p=0.002，p<0.001，p<0.001）。在腹膜液培养中，革兰氏阳性菌的生长最常见于PDrP患者，而革兰氏阴性菌的生长在继发性腹膜炎患者中最常见（p=0.018）。继发性腹膜炎患者的CRP水平和沉降率较高（p<0.001，p=0.003）。结论在不同类型的腹膜炎中观察到的不同特征强调了定制诊断和治疗方法的重要性。CRP水平等参数，沉降速率,和患者年龄可以作为辨别各种类型腹膜炎的有价值的指标。在选择经验性抗生素治疗时，在继发性腹膜炎的PDrP病例中考虑革兰氏阳性病原体和革兰氏阴性病原体的覆盖范围至关重要。
