关键词: 腹膜炎, G+球菌, 肠源性细菌, 再培训

Abstract: 【Abstract】 Objective To investigate the clinical changes of CAPD-related peritonitis from 2011 to 2013 in a single peritoneal dialysis center in order to improve the preventive measures for the peritonitis. Methods Continuous quality improvement (CQI) method was used to analyze the demographic information, incidence, prognosis, pathogenic bacteria, cause of the peritonitis, and frequency of patient training in the CAPD-related peritonitis patients during the period from 2011 to 2013. Results The CAPD-related peritonitis rate in 2011, 2012 and 2013 was one episode/48.8 patient-months, one episode/91.8 patient-month, and one episode/27.9 patient-month (P＜0.001), respectively, demonstrating a “V” profile of the incidence curve. The V-curve changes were also present in the incidences of Gram-positive cocci (P=0.03), and Gram-positive cocci not including enterogenic bacteria (P=0.04). The incidence of enterogenic peritonitis increased gradually in 2011 to 2013 (P =0.05). In the patients with long-term peritoneal dialysis, the ratio of older patients (> 65 years old) increased in 2013 (P=0.01). The rates of annual patient re-training and over-all patient training in older patients were lower in 2012 and 2013 than in 2011 (P＜0.001). Conclusion The increase of CAPD-related peritonitis in 2013 in this peritoneal dialysis center probably resulted from the increase of older patients (>65 years of age) in long-term peritoneal dialysis patients, insufficient education for the prevention of enterogenic peritonitis, and the less frequency of annual re-training for the prevention of CAPD-related peritonitis.

Key words: Peritonitis, Gram-positive cocci, Enterogenic bacteria, Re-training