Estudio bacteriológico del paciente con peritonitis debida a diálisis peritoneal continua ambulatoria en el Hospital General de México

2006 
background: Peritonitis is the most frequent complication of continuous ambulatory peritoneal dialysis (CAPD). Mexico lacks of bacteriological studies that not only analyze the most frequent etiological agent, but also sensitivity, resistance bacterial rates and success with the empiric initial treatment. Objectives: To identify the most frequent microorganism group isolated from cultures of peritoneal fluid in patients with peritonitis as a consequence of continuous ambulatory peritoneal dialysis. To determine sensitivity, resistance bacterial rates and success with the empiric initial treatment. Material and method: A descriptive cross-sectional study was made in patients with peritonitis in continuous ambulatory peritoneal dialysis in the Mexican General Hospital. Peritoneal fluid was centrifuged and sowed in different kinds of cultures, with incubation of 72 h at 37 o C. Bacterial sensitivity and resistance was analysed by Microscan and Kirby-Bauer methods. We observed response to the empiric initial treatment. Results: We identified 80 samples of peritoneal fluid. Gram-negative bacteria were isolated in 46.2% of the cases; E coli in 6.23% and Pseudomonas sp in 11.25%. Gram-positive bacteria were isolated in 31.25%. E. coli was more sensitive to aminoglycosides, quinolones and glycopeptides, and had resistance to ceftazidime. Pseudomonas sp were resistant to most of the antibiotics. S. epidermidis had resistance to betalactamics and sensitivity to vancomycin. S. aureus had sensitivity to betalactamics and vancomycin. Conclusions: Gram-negative bacteria isolation was most frequent in patients with peritonitis in continuous ambulatory peritoneal dialysis in the Mexican General Hospital. Resistance of gram negative and positive bacteria is increasing; nevertheless, sensitivity to vancomycin
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