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김홍수,우준희,한동철,김기업,이상구,이희발,황승덕 대한감염학회 1993 감염 Vol.25 No.4
CAPD has established itself as an alternative therapeutic modality to hemodialysis in the treatment of patients with end stage renal disease. Peritonitis in CAPD patients, despite a continuing decrease in frequency, remains as a major complication and the leading cause of CAPD failure. Polymicrobial bacteremia is an infection caused by two or more microbials in blood representing 6-13% of all bacteremia with variable mortalities from 21 to 54 percent. In Korea the mortality of polymicrobial bacteremia was reported to be 34%. We retrospectively analyzed data from twenty one patients with the polymicrobial peritonitis during CAPD to evaluate the clinical characteristics that may predict polymicrobial perionitis and the mortality rate. Even though there were no unique clinical features to predict the occurrence of polymicrobial peritonitis during CAPD, the mortality rate in the patients with polymicrobial peritonitis was significantly higher than that in the peritonitis caused by singular bacterium (9.5% vs 0.9%). We conclude that attention must be paid to the polymicrobial peritonitis during CAPD because of high mortality in the absence of distinguishing clinical features.
황승덕,이희발 순천향대학교 1985 논문집 Vol.8 No.1
(1) 133명의 환자가 총 110년간 CAPD를 시행하던 중 391회의 복막염이 발생하여 복막염의 발생빈도는 연 평균 3.55회이었으며, 복막염으로 인한 입원 일수는 환자당 연 평균 8.1일이었다. (2) 연도별 복막염의 발생 빈도는 1981년에는 연 평균 6.13회, 1982년에는 4.46회, 1983년에는 3.99회, 1984년에는 2.94회로써 해마다 감소하는 추세를 보이고 있다. (3) 복막염의 발생 시기는 CAPD 시작 후 1주∼1개월 사이가 30.2%로써 가장 많았고, 1∼3개월이 28.1%, 3∼6개월이 17.7%, 1주 이내가 15.6%의 순이었다. (4) 복막염 391회 중 335회(85.7%)는 항생제 투여만으로 치료되었으나, 56회(14.3%)에서는 카테터의 제거가 필요하였고, 281회(71.9%)는 외래 또는 자가 치료되었으나, 110회(28.1%)는 입원 치료를 요하였다. One hundred and thirty-three patients with end-stage renal disease were treated with CAPD over a period of 3,.5 years between March 1981 and September 1984. A total of 391 episodes of peritonitis occurred during 110.21 patient-years of CAPD with the incidence of peritonitis at 3.55 per patient-year. Peritonitis was responsible for 8.1 days of hospitalization per patient-year or 24.4% of total hospital stay. Peritoneal catheter had to be removed once in every 7 episodes of peritonitis. Peritonitis was successfully treated on outpatient basis in 71.9% and by antibiotics only in 85.7%. The incidence of peritioitis has declined progressively during the past 4 years: 6.13 episodes per patient-year in 1981, 4.46 in 1982, 3.99 in 1983 and 2.94 in 1984. Of the 98 patients who were on CAPD as of September 30, 1984, 25 patients had no peritonitis for the last 6 months and 14 of these 25 patients experienced no peritonitis for at least 9 months. It is anticipated that improvement in technology and accumulation of experience will further reduce the incidence of peritonitis associated with CAPD.