腹膜透析相关性腹膜炎患者的病原菌分布与预后影响因素OA

Objective To analyze the prognosis of infections with different pathogens in patients with peritoneal dialysis-related peritonitis(PDRP)and to explore the related factors affecting the prognosis of PDRP.Methods A retrospective cohort study was conducted.Patients with PDRP admitted to a hospital from April 2022 to April 2025 were enrdled as research subjects,and their general information and laboratory test data were collected.Based on prognosis,the patients were divided into a cure group and a withdrawal group.Based on etiological results,the patients were divided into Gram-positive bacterial,Gram-negative bacterial,fungal,mixed bacterial,and culture-negative groups.Pathogen distribution and prognosis in PDRP patients were analyzed,clinical data of patients were compared,and factors influencing the prognosis of PDRP patients were identified.Results A total of 145 patients with PDRP were included,of whom 119(82.07%)had positive etiological cultures.Among the positive cases,74(51.03%)were infected with Gram-positive bacteria,28(19.91%)with Gram-negative bacteria,10(6.90%)with fungi,and 7(4.83%)with mixed bacteria.The mixed bacteria group had higher Creactive protein(CRP)levels and dialysate white blood cell(WBC)counts than the other groups(all P<0.05).The fungal group had lower dialysate WBC counts and polymorphonuclear neutrophil(PMN)percentages than the other groups(all P<0.05).The overall cure rate of PDRP was 82.07%.The cure rates for Gram-positive and Gram-negative bacterial infections were higher than those for fungal and mixed bacterial infections(all P<0.05),and the cure rate for fungal infection was lower than that for culture-negative cases(P<0.05).Univariate logistic analysis showed that older age,low body mass index(BMI),elevated CRP,low serum prealbumin,and hyponatremia were associated with poor prognosis in PDRP(all P<0.05).Multivariate logistic regression identified low BMI as an independent risk factor for poor prognosis(P=0.017).Conclusion Gram-positive bacteria are the predominant pathogens in PDRP patients in this hospital,and the treatment outcomes for Gram-positive bacterial infections are superior to those for infections with other pathogenic types.Patients with fungal peritonitis and mixed bacterial peritonitis have a poorer prognosis.Low BMI is an independent risk factor for poor prognosis in PDRP.Monitoring CRP levels to assess inflammatory status,administering active anti-infective therapy,and strengthening nutritional support are recommended to reduce catheter removal rates and mortality in peritonitis patients.