Abstract:

Objective To analyze the therapeutic effect of vancomycin combined with meropenem to treat peritoneal dialysis-related peritonitis（PDRP） and the influence of serum tumor necrosis factor-alpha（TNF-α）,procalcitonin（PCT）,interleukin（IL）-6 levels and peritoneal fluid white blood cell（WBC） count. Methods A total of 96 patients with PDRP were enrolled,and they were classified into study group（48 cases） and control group（48 cases） by random number table method. The study group was given vancomycin combined with meropenem,and the control group was given vancomycin combined with ceftazidime. Before treatment,the first bag of PDRP patients' peritoneal dialysate was collected,and bacterial culture and drug susceptibility test were performed. The changes of serum TNF-α,PCT and IL-6 levels before and after treatment were compared. Results Gram-positive bacteria,Gram-negative bacteria and other isolates（unexplained） accounted for 60.4%,29.2% and 10.4% in study group,and Gram-positive bacteria,Gram-negative bacteria and other isolates（unexplained） accounted for 56.3%,31.3% and 12.5% in control group,respectively. The distribution of isolates between the 2 groups had statistical significance（P>0.05）. The results of drug susceptibility test suggested that the drug resistance rates of Gram-positive bacteria to vancomycin,linezolid and moxifloxacin were low,and the drug resistance rate of Gram-negative bacteria to meropenem was low. After 21 d of treatment,the cure rate of study group was 91.67%,which was higher than that of control group（81.25%）（P<0.05）. Serum TNF-α,PCT,IL-6 levels and peritoneal fluid WBC count in study group decreased more significantly than those in control group（P<0.05）. Conclusions The prognosis of PDRP patients using vancomycin combined with meropenem is better. Serum TNF-α,PCT,IL-6 levels and peritoneal fluid WBC count can be used as the indicators for PDRP efficacy monitoring.

Key words: Peritoneal dialysis-related peritonitis, Vancomycin, Meropenem, Tumor necrosis factor-alpha, Procalcitonin, Interleukin-6