소아 복막 투석 환자에서 발생한 복막염: 단일기관에서 10년간의 경험 |
이세은, 한경희, 정윤혜, 이현경, 강희경, 정해일, 하일수 |
1서울대학교 의과대학 소아과학교실 2서울대학교 의과대학 소아과학교실 3서울대학교 의과대학 소아과학교실 4서울대학교 의과대학 소아과학교실 5서울대학교 의과대학 소아과학교실 6서울대학교 의과대학 소아과학교실 7서울대학교 의과대학 소아과학교실 |
Peritonitis in Children Undergoing Peritoneal Dialysis: 10 Years' Experience in a Single Center |
Se-Eun Lee, Kyoung-Hee Han, Yun-Hye Jung, Hyun-Kyung Lee, Hee-Gyung Kang, Hae-Il Cheong, Il-Soo Ha |
1Department of Pediatrics, Seoul National University College of Medicine 2Department of Pediatrics, Seoul National University College of Medicine 3Department of Pediatrics, Seoul National University College of Medicine 4Department of Pediatrics, Seoul National University College of Medicine 5Department of Pediatrics, Seoul National University College of Medicine 6Department of Pediatrics, Seoul National University College of Medicine 7Department of Pediatrics, Seoul National University College of Medicine |
Received: September 18, 2010; Revised: September 28, 2010. Accepted: October 11, 2010. |
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ABSTRACT |
PURPOSE: The organisms causing peritonitis and their antibiotic sensitivities vary in different regions and centers, and these data are necessary to establish regional treatment guidelines. The aim of this study was to investigate the changes in incidence and characteristics of the organisms that cause peritonitis in children undergoing peritoneal dialysis (PD) during recent 10 years. METHODS: We retrospectively collected and analyzed the data from medical records of 110 children on PD during the period from 2000 to 2010. RESULTS: One hundred and forty episodes of peritonitis have occurred in 57 patients. The overall incidence of peritonitis was 0.43 episodes/patient.year, and similar incidence have been maintained since 2003. Sixty percent of the patients experienced peritonitis within 1 year of PD, and all patients commencing PD in infancy experienced peritonitis. Gram positive (G (+)), gram negative (G (-)) organisms and fungi were cultured in 58%, 38%, and 4.1% respectively and cultures were negative in 13.6%. Staphylococcus was the most common G (+) organism, and Pseudomonas and Acinetobacter were 2 most frequent G (-) organisms isolated. Fifty-six percent of the G (+) organisms were sensitive to first generation cephalosporin and 91% of G (-) pathogens were sensitive to ceftazidime. Methicillin-resistance rate was not higher in children less than 2 years of age than in those more than 2 years. CONCLUSION: An additional breakthrough has to be made to further reduce the incidence of peritonitis. Treatment guideline customized for peritonitis in Korean children on PD need to be established through a nationwide co-work. |
Key words:
Peritoneal dialysis | Peritonitis | Children |
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