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1 136ﾑ ｧ ｧ9 2006; 18 (1): ｷ302fi020ｸ7apple ｧ ｧ ｧ90ｹ0 0ｸ7applefi 6ｾ40ｸ ｧ ｧ ｸ8026ｧ8 ﾒ : ｸ70407fi020902, 02 6ｧ ｸ ｧ9 020ｷ307 apple fi070ｷ fi0ｹ0 02 閨 ｸ7 ﾒ. ｦ ｨB 07 閨02080ｸ ﾞ ｹ02 ｦﾌ. ﾞ07020ｷ30708apple086ｦ003080ｸ71 ﾞ. ﾒ applefi ｦﾌ ｸ ｹ02. ｦ 04080ｸ ｹ ﾆ ｹ02 6ﾑ ｸ fi fi ｦ 006ｧ800, 縺03 ﾞ 00. 縺 ｹ003, ﾞ036ｧ ｧ ｾ40208applefi0ｹ0: ) ﾇ 閨 ｷ ｸ ｧ90ｷ ｹ0 apple ｧ ｹ ｧ90ｹ0 0ｸ7applefi 6ｾ40ｸ ｧ ｧ ｸ8-026ｧ8 ﾒ (6ｾ40209 ﾒ), ｸ70407fi apple0800fi070ｷ304090ｹ 閨 ｹ0 000ｸ ｧ9 0ｹ ｸ70ｹ ｸ70ｹ ｦ00ｹ0 apple ｹ0. 6 5) ﾇ 00apple ｧ ｹ0 apple03 閨 ｹ ｧ80ｹ0 0000apple ｧ80ｹ apple006ｧ9 0ｹ0. 09) ﾇ ｧ ｹ0 040ｸ70407fi ｹ ｹ0 apple ｧ ｹ0 (incidence) ｧ90ｹ0 0ｸ7applefi 6ｾ40209 ﾒ (00apple000604fi 06 / ｧ8/ 閨02080ｹ0) 閨0ｹ ｹ fi-09 閨 : ｧ fi03000ｹ ｹ0 apple000306apple ｹ0 apple ｧ ｹ ｧ90ｹ ｾ40209 ﾒ applefi ｦﾐ 07080ｸ ｸ 閨0ｷ30ｹ 閨 ｸ apple ｸ ｸ > ｸ ｦ /00L ｧ fi fi ｧ ｦ ｹ ｸ 閨 , 100 ml apple ｸ ｦ0 0ｸ ｦ0, ｧ9ｨB ｨBfi BacTAlert (BacTAlert system, Bio Merieux, France) 6ｧ8 BacTec (Becton Dickinson, Meylan Cedex, France) ｹ apple ｸ ( ｦ , fi ｸ707, MacConkey, Sabouraud dextrose ). H 020ｸ7apple08apple086ｧ ｷ apple080ｸ7 apple 閨 ｸ704026ｧ API 20 E, API 20 NE, API STAPH, API STREP, Coryne API VITEK-2 (biomerieux Vitek two France). O 閨 ｹ ｹ0 000ｸ ｧ9 0ｹ 閨 閨 ｹ ｸ704090ｹ0 020ｷ307 6ｧ ｷ307 (Kirby-Bauer) 0400 Mueller-Hinton ｸ7apple fi0ｹ0 020ｷ307 MICs 0000 E-test (AB Biodisk Solna, Sweden) ｦ VITEK 閨0409. ﾞapple 閨 : ﾒ ｹ 閨02090ｹ0, ｧ90ｹ apple000604fi 06 apple ｧ ｹ0, 74 (80,43%) ｧ 閨 ｸ7 apple ｸ802086ｦ0 0ｸ ｦ (19,57%) ｧ8. ﾇ 090ｷ ｧ8 apple ｧ90206 (090ｷ ｧ9 apple ｸ802086ｦ0 0ｸ ｦ0) apple ｧ applefi 02060ｹ0 apple000306apple ｹ0 apple ｧ ｹ ｸ , fi 020ｸ ｷ307 >100/00L ｧ 閨 Aapplefi apple000604fi 06, 0ｷ30ｹ0 00fi0708 6ｧ apple ｧ ｹ0, apple Gram , Gram ｧ Candida spp (68,92%), 19 (25,68%) (2,70 %) apple000306apple ｹ ｧ ｦ008 (2,70%) 00apple000604fi ｧ80ｹ ｧ9000ｷ301090ｹ > ｧ80306 (Enterococcus, E. coli) apple ｧ applefi 036ｧ 閨03080ｸ7. O ｸ ｧ ｸ703fi (CoNS) Enterococcus spp apple

2 13 ﾒ. ｦ ﾆ ﾞ036ﾑ8ｦ O08 ﾒ ﾞｦﾐ 6ｾ ﾑ ｧ o03o096ｧ9 18, (37,84%) (16,21%) apple000306apple ｹ ｧ Gram Corynebacterium spp, Bacillus spp S. aureus apple apple , 5,41%, 5,41% ,70% 07026ｧ fi0708 apple00036ｧ9apple020ｷ30409 (1,35%) apple ｧ ｹ0 applefi fi (Clostridium histolyticum) O Proteus mirabilis (5,41%) Pseudomonas aeruginosa (4,05%) 020ｸ7apple08apple08066ｧ ｷ30ｹ ｸ70407fi ｧ90206 apple ｧ ｹ0 applefi Gram ｧ ﾇ 00026ｧ ｸ70407fi ｹ0 apple ｧ ｹ0 020ｸ fi02 07 applefi 1,3-1,7. O 閨 ｹ0 000ｸ ｧ9 0ｹ fi apple fi ｧ80ｹ0 (17,85%) 020ｷ307 CoNS methicillin (MRS) ｸ ｧ9 fi030ｷ ｷ307 Enterococcus spp vancomycin fi apple fi (50%) 020ｷ307 Enterococcus 006ｧ ｸ ｦ0 00apple06apple 陦080ｸ ｧ gentamicin Gram ｧ apple08030ｸ7000ｸ7 6ｧ fi0ｹ0 applefi 閨0409 Acinetobacter baumannii. 6ｾ40ｸ700apple : ) ｦ Gram ｧ ｷ30ｹ0 6ｧ90206 apple ｧ ｹ ｧ90ｹ ｾ40209 ﾒ apple ｦ007 2, 閨0ｹ0 040ｸ70407fi applefi 02 Gram ) O06 CoNS, ｸ703086ｦ applefi 02080ｸ70ｹ fi ｸ70ｹ0 006ｧ apple03 閨 ｸ ｧ90206 apple ｧ ｹ0. 09) ﾇ apple0800fi070ｷ30409 apple fi ｷ ｸ7 0007fi0ｹ ｧ90ｷ307 apple ｧ ｸ7036ｧ8 閨 ｸ apple 03086ｦ00ｹ0 apple ｧ ｹ ｧ90ｹ ｾ40209 ﾒ. ) 閨 ｹ0 apple0804fi ｹ0 apple ｸ802086ｦ0 0ｸ ｦ apple fi apple ｧ ｹ ｧ 閨 apple 閨 ｸ fi. 00) ﾇ 0000apple ｧ ｧ80409 vancomycin + ceftazidime ｸ70407fi apple0800fi070ｷ304090ｹ0 020ｷ ｸ ｧ ｸ70ｹ ｦ0apple fi 02006ｧ800 apple fi ｦ003080ｹ0 020ｷ ｧ90ｷ ｹ0 apple ｧ ｹ ｧ90ｹ0 0ｸ7applefi 6ｾ40209 ﾒ. 0402) ﾇ 00apple ｧ ｹ0 0000apple ｧ80ｹ apple006ｧ9 0ｹ0 03 apple03 鐶pple ｧ ｧ 閨 apple fiｨB apple06026ｧ8 00apple ｧ ｹ0 apple ｧ ｹ0. 閨 ｹ : 090ｷ ｧ8 apple ｧ90206, 閨 apple ｸ802086ｦ0 0ｸ ｦ0, apple ｧ90206, 040ｸ ｧ80ｹ ｧ8 apple ｸ8026ｧ ｾ ｧ8 0ｸ7026ｧ 閨 ｸ ｧ ｹ0 apple ｧ ｹ ｧ90ｹ0 0ｸ7applefi 6ｾ40209 ﾒ, ｸ70407fi apple0800fi- 070ｷ304090ｹ ｸ ｧ ｸ70ｹ ｦ00ｹ0 apple ｹ0. ｦﾌ ｸ7 0208apple ｦ 閨03080ｸ ｧ9000ｷ301090ｹ ｹ ｧ80ｹ , ｧ apple03 閨 apple fi apple000ｸ fi 04046ｧ ｧ8 0000apple ｧ ｸ ｷ ｸ70407fi ｷ ｧ90ｷ307 apple ｧ ｹ0. ｦ 閨03080ｹ ｧ ｸ70407fi ｹ0 apple ｧ ｹ0 (incidence) ｧ90ｹ0 0ｸ7applefi 6ｾ40209 ﾒ (00apple000604fi 06 / ｧ8/ 閨02080ｹ0) ｹ 閨0ｹ ｹ ( ). ﾞ ｧ90ｹ0 ｨC 00 閨 ｧ ( applefi ｦﾐ 07080ｸ ｸ 閨0ｷ30ｹ 閨 ｸ7 2004) fi apple fi 06 apple ｧ ｹ ｧ90ｹ0 0ｸ7applefi 6ｾ40209 ﾒ. ﾇ ｷ ｹ0 apple ｧ ｹ0 閨 fi fi ｧ80ｹ0 apple 03080ｸ7046ｧ9 ｨB00 6ｦ ｸ applefi 02 02fi03080ｸ ｧ apple ｧ8apple ｸ707 0ｸ7-0400fi: 1) 040ｸ700apple ｧ9 apple ｸ8026ｧ80ｹ ｧ80ｹ0 (6ｧ8apple fi0ｹ0 applefi07080ｹ0, fi0ｹ0 apple0ｸ fi0ｹ ｧ8apple ｧ8 000ｸ ｧ9 ), 2) apple ｸ ｸ > ｸ ｦ /00L % apple08030ｸ apple6ｦ ) ｧ Gram ｧ 閨 ｸ7 apple ｸ802086ｦ0 0ｸ ｦ0 1. ﾇ 090ｷ ｧ8 apple ｧ90206 (090ｷ ｧ9 apple ｸ802086ｦ0 0ｸ ｦ0) apple ｧ applefi 02060ｹ0 apple000306apple ｹ0 apple ｧ ｹ ｸ , fi 020ｸ ｷ307 >100/00L ｧ 閨 ﾇ 090ｷ ｧ ｸ7 apple ｸ802086ｦ0 0ｸ ｦ ｧ9ｨB applefi apple 03080ｸ7046ｧ9 > ｷ ｧ9030ｷ307/00L 6ｧ8 >10% 090ｷ ｧ9030ｷ ｸ ｦ ｦ0 020ｷ ｸ ｸ ｷ307. ﾇ ｧ ｷ ｧ fi ｸ ｹ0 090ｷ ｧ80ｹ0 apple ｧ ｹ0: 2 1) ｹ0 apple ｸ802fi 0ｸ70903fi ｧ9apple080ｸ , 2) apple080ｸ7046ｧ9 apple0ｸ ｦ0, 3) 00apple000604fi ｧ80ｹ0 0ｸ ｧ9 0ｹ apple080ｸ7046ｧ ｧ80ｹ0 000ｸ ｧ9 0ｹ0, 4) fi 03000ｸ ｸ ｷ307 >100/00L (040ｸ7-076ｧ8030ｷ30ｹ /00L) 0000 <60% apple08030ｸ apple6ｦ , 5) applefi030ｸ fi 090ｷ ｧ9030ｷ307 >100/00L 6ｧ8 >10% 090ｷ ｧ9030ｷ ) ｧ 閨 ﾇ ｧ ｧ ｸ ｧ9080ｸ7 0001fi 080ｸ ｸ ｧ803 apple apple036ｦ ｧ 閨 povidone iodine (betadine 6ｧ8 oxisept), 01 鐶pple030ｸ apple ｷ300 閨 fi (water for injection), 0402 閨09070ｷ apple ｷ300 閨 ｨB, ｧ8 betadine solution apple ｸ ｸ fi ｨB. 030ｹ0 00 閨03080ｹ ｹ ｧ80ｹ ｧ9 0ｹ ｸ ｧ9080ｸ7 0001fi 080ｸ ｸ ｧ803 applefi 02080ｸ70ｹ ｧ90ｹ0, ｨBfi ｧ8 mupirocin (bactroban) apple03fi ｷ ｷ307 applefi S. aureus fi0406 apple fi applefi 閨0ｹ apple08080ｸ7096ｧ apple020ｸ701090ｹ ｧ90ｷ apple ｦ00ｹ0 00apple6ｧ ｹ ｧ apple ｸ ｸ > ｸ ｦ /00L ｧ fi fi ｧ ｦ ｹ0. 縺 閨 ｸ7 apple ｸ802086ｦ0 0ｸ ｦ fi apple fi applefi Isenberg 00 閨 ｹ03. ﾇ ｧ8 apple fi03080ｸ : 1) ｸ7 apple 閨07080ｸ ｸ ｸ 閨0ｹ0, 2) apple08036ｦ ｸ ｧ9080ｸ7 036ｧ ｹ ｷ

3 136ﾑ ｧ ｧ9 18, ﾑ806ｦﾐｦ O03ｦﾐｦ ｦﾐ04 ﾞ 6ｾ46ﾑ8 ﾞ6ｾ4056ﾑ8036ﾑ8ｦﾐ6ｾ4 0809O 6ｾ408036ﾑ801 ﾇ 02O06 ﾇｦ ﾇ 096ﾑ806ｦﾐｦ O03 ﾞ07 ﾒ ﾇ ﾒ ﾞ05 ﾞ066ｾ4 ﾇ ( ) povidone iodine ｧ ml 0ｸ ｦ0, 3) 036ｧ ｸ ｷ307, 4) 0208apple0803 閨 ｸ7 0ｸ ｦ ｷ ｷ ml ｸ 閨 min g, 5) apple ｧ8 applefi ml 0ｸ7apple 閨07080ｸ7 applefi ｷ ｦ ｸ7 06ｨB6ｧ ｹ0, 6) apple036ｦ ｸ7 06ｨB6ｧ ｹ apple ｧ ml apple ｷ300 閨07080ｸ7 D.W apple ｷ ｧ90ｷ ) apple086ｧ ｸ7 06ｨB6ｧ ｹ fi 020ｷ307 0ｸ apple ｸ76ｧ8 00apple ｧ ｹ Gram. ｦ 08 6ｧ9ｨB ｨBfi BacTAlert (Bac TAlert system, Bio Merieux, France) 6ｧ BacTec (Becton Dickinson, Meylan Cedex, France) ｹ0 ( 0003fi ｹ fi ｹ0), apple080ｸ7 00apple0ｷ307ｨB 閨03000ｹ apple ｸ ( ｦ , fi ｸ707, MacConkey, Sabouraud dextrose ). H 020ｸ7apple08apple086ｧ ｷ apple080ｸ7 apple 閨 ｸ704026ｧ API 20 E, API 20 NE, API STAPH, API STREP, Coryne API (biomerieux France) VITEK 2 (biomerieux Vitek two France). O 閨 ｹ ｹ0 000ｸ ｧ9 0ｹ 閨 閨 ｹ ｸ704090ｹ0 020ｷ307 6ｧ904020ｷ307 (Kirby-Bauer) 0400 Mueller-Hinton ｦ000080ｷ ｹ0 040ｸ ｹ ｸ7 NCCLS ｸ7apple fi0ｹ0 020ｷ307 MICs 0000 E-test (AB Biodisk Solna, Sweden) ｦ VITEK 閨 ｾ ｧ ｸ70409 O ｧ ｹ 閨0ｹ ｹ0 apple ｧ ｹ0 (00apple000604fi- 06 / ｧ8/ 閨02080ｹ0) ｯ 閨02080ｹ 閨0ｹ ｸ7-0407fi apple0800fi070ｷ304090ｹ0 020ｷ307 Gram Gram ｧ90ｷ ｸ ｧ ｦ x ｸ7 Pearson ｧ ｸ7 apple ｹ0 SPSS for windows version 12. ﾞapple 閨 ﾒ ｹ 閨02090ｹ0, ｧ90ｹ apple000604fi 06 apple ｧ ｹ0, 74 (80,43%) ｧ 閨 ｸ7 apple ｸ ｦ0 0ｸ ｦ (19,57%) ｧ8 (096ｧ907. 1). Aapplefi apple000604fi 06, 0ｷ30ｹ0 00fi0708 6ｧ apple ｧ ｹ0, apple Gram , Gram ｧ Candida spp (68,92%), 19 (25,68%) (2,70 %) apple000306apple ｹ ｧ (096ｧ907. 2). 046ｦ008 (2,70%) 00apple000604fi ｧ80ｹ ｧ9000ｷ301090ｹ > ｧ80306 (Enterococcus, E. coli) apple ｧ applefi 036ｧ 閨03080ｸ7. O ｸ ｧ ｸ703fi (CoNS) Enterococcus spp apple (37,84%) (16,21%) apple000306apple ｹ ｧ Gram Corynebacterium spp, Bacillus spp S. aureus apple apple ,41%, 5,41% ,70% 07026ｧ ｧ9 00fi0708 apple00036ｧ9- apple020ｷ30409 (1,35%) apple ｧ ｹ0 applefi fi6 506 (Clostridium histolyticum) O Proteus mirabilis (5,41%) Pseudomonas aeruginosa (4,05%) 020ｸ7apple08apple08066ｧ ｷ30ｹ ｸ70407fi ｧ90206 apple ｧ ｹ0 applefi Gram ｧ80306 (096ｧ907. 3). ﾇ 00026ｧ ｸ70407fi ｹ0 apple ｧ ｹ0 020ｸ fi02 07 applefi 1,3-1,7. O ｧ ｹ 閨0ｹ0 020ｷ ｹ0 apple ｧ ｹ ｯ 閨02080ｹ 閨0ｹ ｸ7-0407fi apple0800fi070ｷ304090ｹ0 020ｷ307 Gram Gram ｧ90ｷ 閨 閨0ｹ0 (p=0,757) (096ｧ907. 4). O 閨 ｹ0 000ｸ ｧ9 0ｹ 陦 fi apple fi ｧ80ｹ0 (17,85%) 020ｷ307 CoNS methicillin (MRS) ｸ ｧ9 fi030ｷ ｷ307 Enterococcus spp vancomycin fi apple fi (50%) 020ｷ307 Enterococcus 006ｧ ｸ ｦ0 00apple06apple 陦080ｸ ｧ gentamicin (096ｧ907. 5) Gram ｧ apple08030ｸ7000ｸ7 6ｧ fi0ｹ0 applefi 閨0409 Acinetobacter baumannii (096ｧ907. 6). 096ｧ ｹ0 1. 6ｾ40ｸ70407fi apple ｧ9 0ｷ ｧ ｧ 閨 閨 ﾑ8apple000604fi 06 ﾞ ｧ90ｹ apple000604fi ｧ ｹ ｧ ｹ apple ｧ ｹ0 apple ｧ ｹ 閨0ｹ 閨 ｹ 閨0ｹ 閨 ｹ (74) 80,43% (18) 19,57% 096ｧ ｹ0 2. 6ｾ40ｸ70407fi apple0800fi070ｷ304090ｹ ｸ ｧ90ｷ307 apple ｧ ｹ apple080ｸ7 0ｸ7apple ｧ ｾ40209 ﾒ 閨 Gram ｧ80306 ( 閨07 6ｧ ) Gram ｧ80306 ( 閨07 6ｧ ) ｧ ｧ9000ｷ ｦ ｹ0 (51/74) 68,92% (19/74) 25,68% (2/74) 2,70% (2/74) 2,70% 51

4 13 ﾒ. ｦ ﾆ ﾞ036ﾑ8ｦ O08 ﾒ ﾞｦﾐ 6ｾ ﾑ ｧ o03o096ｧ9 18, ｧ ｹ0 3. ｦﾌ ｸ ｧ apple000306apple ｷ307 apple ｧ ｹ apple080ｸ7 0ｸ7apple ｧ ｾ40209 ﾒ ｷ O ｧ9 6ｾ40ｸ70407fi apple0800fi070ｷ304090ｹ0 n (%) coagulase ｧ9 Staphylococci (S. epidermidis, S. capitis, S. hominis, S. hyicus, S. haemolyticus, S. warneri) 28 (37,84) Staphylococcus aureus 2 (2,70) Streptococcus viridans 1 (1,35) Enterococcus faecalis 9 (12,16) Enterococcus faecium 3 (4,05) Corynebacterium spp 4 (5,41) Bacillus spp 4 (5,41) Pseudomonas aeruginosa 3 (4,05) Pseudomonas stutzeri 1 (1,35) Pseudomonas fluorescens/putida 2 (2,70) Enterobacter cloacae 1 (1,35) Enterobacter agglomerans 1 (1,35) E. coli 2 (2,70) Proteus mirabilis 4 (5,41) Stenotrophomonas maltophilia 2 (2,70) Acinetobacter baumannii 1 (1,35) ｧ ｧ9000ｷ30109 applefi E. faecalis E. coli 1 (1,35) Acinetobacter lwoffii 1 (1,35) ｧ ｧ9000ｷ30109 applefi E. faecalis, Citrobacter koseri Acinetobacter baumannii 1 (1,35) Clostridium histolyticum 1 (1,35) Candida albicans 1 (1,35) Candida glabrata 1 (1,35) 6ｾ46ｦ ｧ ｹ0 4. 6ｾ40ｸ70407fi (00apple000604fi 06 / ｧ8/ 閨02080ｹ0) ｧ ｹ 閨0ｹ ｸ70407fi apple0800fi070ｷ304090ｹ0 020ｷ ｧ90ｷ307 apple ｧ ｹ 閨 ﾞ ｧ90ｹ ｾ40209 ﾒ (n) ﾑ8apple000604fi 06 apple ｧ ｹ0/ ｧ90ｹ0 (n) 25/15 17/13 29/17 21/15 6ｾ40ｸ70407fi (00apple000604fi 06 / ｧ8/ 閨02080ｹ0) 1,6 1,3 1,7 1,4 ﾞ ｧ90ｹ ｸ7apple apple0607ｨB080ｸ704 apple ｧ90206 n (%) 1/15 (6,7) 1/13 (7,7) 2/17 (11,8) 1/15 (6,7) ﾒ 閨 ｧ8 n (%) 5 (20) 4 (23,53) 5 (17,24) 4 (19,05) ｦﾌ 02026ｧ80306 Gram n (%) 16 (80) 10 (76,92) 13 (54,17) 12 (70,59) Gram n (%) 4 (20) 3 (23,08) 8 (33,33) 4 (23,53) ｧ ｧ9000ｷ30109 n (%) (8,33) 0 096ｦ ｹ0 n (%) (4,17) 1 (5,88) 6ｾ46ｦ n (%) 20 (100) 13 (100) 24 (100) 17 (100) 6ｾ40ｸ7ｨB6ｧ ﾇ apple ｧ90206 apple 閨 fi ｦ apple06apple ｧ ｹ0 6ｾ40209 ﾒ 閨 ｧ8 apple ｧ apple ｧ ｧ apple08020ｸ7046ｧ ｹ0 apple ｸ8026ｧ80ｹ ｹ0. 縺 fi0908 0ｸ702fi, ｧ ｷ 閨 ｹ apple006ｧ9 0ｹ ｹ0 apple ｧ ｹ0, apple apple0800fi070ｷ ｸ ｦ0 apple080ｸ apple , 006ｧ ｧ ｧ8 閨 ﾇ 00apple ｧ ｸ ｸ ｦ ｧ9ｨB apple06026ｧ8 00apple ｧ9 020ｷ ｦ ｷ apple080ｸ7 apple ｦ ｧ9000ｷ ｸ ｧ ｸ70ｹ ｸ70ｹ ｦ00ｹ0 apple ｹ ｧ ｸ 閨0ｹ0 040ｸ ｦ007 fi apple0600 閨03080ｸ70ｹ0 02 閨 apple03 鐶pple ｸ ｹ0 07 apple ｸ703086ｦ apple ｧ ｹ0 apple ｧ ｹ ｧ90ｹ ｾ40209 ﾒ, apple030ｷ302fi apple006ｧ9-0ｹ0 07 apple fiｨB ｹ0 0208apple0602 閨0ｹ0 040ｸ707036ｧ802000ｹ ｸ7 52

5 136ﾑ ｧ ｧ9 18, ﾑ806ｦﾐｦ O03ｦﾐｦ ｦﾐ04 ﾞ 6ｾ46ﾑ8 ﾞ6ｾ4056ﾑ8036ﾑ8ｦﾐ6ｾ4 0809O 6ｾ408036ﾑ801 ﾇ 02O06 ﾇｦ ﾇ 096ﾑ806ｦﾐｦ O03 ﾞ07 ﾒ ﾇ ﾒ ﾞ05 ﾞ066ｾ4 ﾇ ( ) 096ｧ ｹ0 5. ﾞ ｧ8 (%) 020ｷ307 apple ｷ303 閨07020ｷ307 GramｨC ｧ90ｷ ｸ70ｹ ｦ00ｹ0 apple ｹ 閨 ｨC2004 6ﾑ86ｧ9 080ｹ0 GramｨC ｦ ｧ9080ｸ7 (n=53) ﾞ ｧ ｸ70ｹ ｦ00ｹ0 apple ｹ0 % AMP OX CL TET SXT RF FA MUP VA TEC GN CIP CoNS (28) (25/28) (5/28) 0 (3/28) (1/28) 0 (10/28) (9/28) 0 89,28 17,85 3,57 35,71 32,14 E. faecalis (11) 0 ｨC ｨC (3/11)ｨC ｨC ｨC ｨC ｨC 0 0 (5/11) ｨC 27,3 45,45 E. faecium (3) (3/3) ｨC ｨC 0 ｨC ｨC ｨC ｨC 0 0 (2/3) ｨC ,7 Corynebacterium spp (4) 0 ｨC 0 0 ｨC 0 ｨC ｨC S. aureus (2) (1/2) S. viridans (1) 0 ｨC ｨC ｨC ｨC Bacillus spp (4) (2/4) ｨC (2/4) 0 0 (1/4) ｨC ｨC AMP: ampicillin, OX: oxacillin, CL: clindamycin, TET: tetracycline, SXT: sulfamethoxazole-trimethoprin, RF: rifampicin, FA: fusidique, MUP: mupirocin, VA: vancomycin, TEC: teicoplanin, CIP: ciprofloxacin, GN: gentamicin, ｨC:

6 13 ﾒ. ｦ ﾆ ﾞ036ﾑ8ｦ O08 ﾒ ﾞｦﾐ 6ｾ ﾑ ｧ o03o096ｧ9 18, ｧ ｹ0 6. ﾞ ｧ8 (%) 020ｷ307 apple ｷ303 閨07020ｷ307 GramｨC ｧ90ｷ ｸ70ｹ ｦ00ｹ0 apple ｹ 閨 ｨC2004 6ﾑ86ｧ9 080ｹ0 GramｨC ｦ ｧ9080ｸ7 (n=22) ﾞ ｧ ｸ70ｹ ｦ00ｹ0 apple ｹ0 % AMP CXM CRO CAZ FEP AZT TZP TCC AMC SXT AK GN TB NT CIP IMP P. aeruginosa (3) ｨC ｨC ｨC ｨC ｨC Enterobacter cloacae (1) (1/1) (1/1) (1/1) E. coli (3) (1/3) ,3 Proteus mirabilis (4) (3/4) (2/4) Pseudomonas stutzeri (1) ｨC ｨC ｨC P. fluorescens/putida (2) ｨC ｨC ｨC Citrobacter koseri (1) Acinetobacter baumanii (2) (2/2) (2/2) (2/2) (2/2) (2/2) (2/2) (2/2) (2/2) (2/2) (2/2) (2/2) (2/2) (2/2) (2/2) (2/2) Acinetobacter lwoffii (1) (1/1) S. maltophilia (2) (2/2) (2/2) (1/2) (1/2) (1/2) (1/2) (1/2) 0 (2/2) 0 (1/2) (1/2) (2/2) 0 (1/2) (2/2) E. agglomerans (1) (1/1) Clostridium histolyticum (1) 0 ｨC ｨC ｨC ｨC ｨC ｨC ｨC ｨC ｨC ｨC ｨC 0 AMP: ampicillin, CXM: cefuroxime, CAZ: ceftazidime, CRO: ceftriaxone, FEP: cefepime, AZT: aztreonam, TZP: piperacillinｨctazobactam, TCC: ticarcillinｨcclavulanate, AMC: amoxicillinｨcclavulanate, CIP: ciprofloxacin, AK; amikacin, GN: gentamicin, NT: netilmicin, TB: tobramycin, IMP: imipenem, ｨC:

7 136ﾑ ｧ ｧ9 18, ﾑ806ｦﾐｦ O03ｦﾐｦ ｦﾐ04 ﾞ 6ｾ46ﾑ8 ﾞ6ｾ4056ﾑ8036ﾑ8ｦﾐ6ｾ4 0809O 6ｾ408036ﾑ801 ﾇ 02O06 ﾇｦ ﾇ 096ﾑ806ｦﾐｦ O03 ﾞ07 ﾒ ﾇ ﾒ ﾞ05 ﾞ066ｾ4 ﾇ ( ) 02 閨 ｸ74. ｦ fi 6ｧ ｹ0 apple ｧ ｹ ｸ70ｹ ｧ90ｹ0 0ｸ7applefi 6ｾ40209 ﾒ, fi0ｹ0 applefi 6ｦ008 apple000306apple ｹ0 000ｸ apple 03086ｦ00ｹ0 apple ｧ ｹ0, 0ｸ7apple6ｧ 閨07, 0000 apple0308- 閨03000ｸ ｷ3036ｧ ｸ7 閨 ｹ0 6ｧ ｸ 閨03080ｸ7. ｦ apple ｷ307 Gram (68,92%) Gram (25,68 %) 02090ｹ 閨02090ｹ0 00 0ｹ0 020ｸ700 6ｧ 閨 ｦ003080ｹ0 020ｷ307 apple apple080ｸ 閨 applefi ｹ 閨02000ｹ ｾ402060ｹ 閨02000ｹ0 0ｸ702 閨0ｹ0, apple ｸ70407fi 6ｧ ｧ CoNS, ｦ ｧ apple080ｸ ｸ703006ｧ9 006ｧ S. aureus 閨 fi 00 0ｹ0 02 閨 ｦ , apple080ｸ7 閨 ｧ apple ｧ ｸ ｦ0 0000apple ｦ ｧ ｹ0, 006ｧ fi ｸ70407fi ｧ apple ｧ ｹ ｸ70ｹ0 CoNS 006ｧ fi , 06 6ｧ90ｷ30ｹ0 08 E. faecalis. O fi apple ｦ 閨03080ｹ ｹ ｷ3036ｧ9 0ｹ ｸ 閨03080ｸ ｧ ｸ707 00fi030ｸ fiapple , fi 閨 apple fi 閨04080ｸ ｸ7 02 閨 ｸ ｹ ｸ ｸ7. ﾇ apple ｧ90206 applefi S. aureus, 09 08apple086ｧ9 006ｧ ｧ ｧ9000ｷ ｹ 閨07080ｸ ｦ0 applefi07080ｸ7, 0ｸ7applefi ｹ0 02fi apple036ｧ803080ｸ70ｹ0 shock, 006ｧ apple ｧ90ｹ ｸ ｧ800 02fi0ｹ0 00 0ｹ0 (2,7%) ｷ30ｹ0 09 apple apple ｧ ｧ8 mupirocin (bactroban) ｧ fi 080ｸ ｸ ｧ ｧ apple08036ｦ fi apple fi 03086ｧ9000ｷ301090ｹ0 applefi S. aureus 8. 6ｾ40ｸ7076ｧ8030ｷ30ｹ0 09 apple ｧ ｧ9ｨB ｹ ｸ ｧ803 ( ｧ fi 080ｸ ｸ ｧ803 6ｧ8 0ｸ7apple08 fi ｧ ) apple fi030ｸ apple 086ｧ80ｹ0. ﾞapplefi 02060ｹ0 6ｦ008 apple000306apple ｹ0, ｧ9 040ｸ707 00fi ｧ9000ｷ ｸ ｧ9080ｸ7 0001fi 080ｸ ｸ ｧ803. O Proteus mirabilis Pseudomonas aeruginosa 6ｧ ｸ70407fi ｧ90206 apple ｧ ｹ0 applefi Gram ｧ ﾇ apple ｧ90206 applefi P. aeruginosa 006ｧ ｧ ｧ9000ｷ ｸ7076ｧ8030ｷ30ｹ0 040ｸ707 閨 , fiapple0ｷ30ｹ ｧ90709 applefi S. aureus, ｧ9000ｷ ｸ ｧ803. 6ｾ402060ｹ0 6ｦ008 applefi 02060ｹ ｹ0 apple000306apple ｹ ｹ 閨02090ｹ0 00 0ｹ0 040ｸ7070ｸ7apple6ｧ ｧ9000ｷ ｸ ｧ9080ｸ7 0001fi 080ｸ ｸ ｧ ｧ ｹ0 apple080ｸ7 040ｸ707 閨 ｹ ｸ ｧ803 (040ｸ7076ｧ ｧ90206 S. aureus, P. aeruginosa) 006ｧ 閨0ｹ apple006ｧ apple ｦ007 閨 ｧ ｹ ｹ ｸ ｧ803. O06 apple ｧ ｹ0 applefi Stenotrophomonas maltophilia Acinetobacter spp, apple080ｸ7 006ｧ ｸ707 00fi030ｸ applefi 0208 apple , 040ｸ7076ｧ8030ｷ30ｹ0 applefi fi, 6ｧ apple ｹ0. ﾇ apple ｧ90206 applefi fi ｧ apple ｾ ｧ9 00fi0708 apple00036ｧ9apple020ｷ30409 apple ｷ30ｹ0 6ｧ Clostridium histolyticum, 0906 ｯ 0ｸ702fi ｧ ｸ 閨0ｹ ｷ ｧ apple 03 6ｧ 閨 ｸ7 apple ｸ802086ｦ0 0ｸ ｦ fi 縺 ｧ90ｷ ｸ7 apple ｦ0 020ｷ ｸ 閨 ｨB6ｧ ｹ ｸ 閨 ml apple ｸ802086ｦ0 0ｸ ｦ 閨 apple08036ｦ ｦ ｹ0 apple0804fi ｹ0 0ｸ ｦ ｧ80409 BacTAlert 閨 , 0208 apple fi 020ｷ307 apple000306apple ｷ307 apple ｧ ｹ ｧ 閨 apple 閨 fi00 0ｸ fi fi ｦ applefi apple fi fi (20%). ﾇ 040ｸ70407fi ｹ0 apple ｧ ｹ 閨 ｹ0 006ｧ ｦ ｹ fi ｹ0, 06fi ｧ ｧ90ｹ0 (6,7-11,8% 020ｷ apple ｧ 閨02080ｹ0) ｸ7apple apple0607ｨB080ｸ704000ｹ0 apple ｧ ｹ0, apple086ｧ9000ｹ ｷ3apple6ｧ ｷ30ｹ0, ｧ ｸ ｧ8-03, applefi 閨0ｹ0 apple030804apple ｹ apple006ｧ9-0ｹ ｸ707 0ｸ7 0400fi , ｸ fi070ｷ30ｹ0 閨 apple030804apple ｧ ｹ ｹ ｸ fi ｹ ｹ0 apple ｸ8026ｧ80ｹ ｹ fi03 0ｸ70207 apple 閨 ｸ fi applefi apple ｧ ｧ8 ( 閨07 00apple000604fi 0608/ ｧ8/18 006ｧ807000ｹ0) 11. ｦ ｦ ｧ ｸ7apple apple0607ｨB080ｸ704 0ｹ0 apple ｧ ｹ 閨 ｹ0 6ｧ S. epidermidis fi ｸ ｧ Enterococcus Proteus mirabilis ｹ apple000306apple ｹ ｷ3apple6ｧ apple06020ｸ704060ｹ0 040ｷ3036ｧ90ｹ ｸ ｧ803. 6ﾑ ｧ ｹ ｧ ｸ ｧ803 apple ｦ007: ) ｧ8 apple ｧ90206 ( apple08020ｸ7046ｧ9 06 6ｦ ｹ ｸ7 apple ｸ802086ｦ0 0ｸ ｦ applefi ｧ apple006ｧ ｹ ), 6 5) 09 0ｸ7apple apple0607ｨB080ｸ704 apple ｧ90206, 09) ｸ ｧ8 apple ｧ ) ｧ ｧ9000ｷ ｸ ｧ803 ( ｧ fi 080ｸ7 6ｧ8 0ｸ7apple08 fi0306 0ｹ0 046ｧ ｹ0). 6ｾ fi 02006ｧ ｸ ｧ9080ｸ7 00 0ｹ0 0ｸ7apple ｹ ｧ ｦ ｧ803 0ｹ0, apple fi ｹ 閨0ｹ apple006ｧ9 apple000306apple ｹ012. 6ﾑ8apple0006 6ｧ ｧ ｹ0 040ｸ70407fi ｹ ｹ0 apple ｧ ｹ0 apple 閨07080ｸ707 0ｸ fi ｹ0 020ｷ ｷ307 apple ( ｧ8 020ｷ ｷ apple ｦ ｹ ｸ7apple6ｧ ｧ8), applefi0ｹ0 00 0ｹ0 006ｧ apple ｦ ｹ0 040ｸ70407fi ｹ ｹ0 apple ｧ ｹ ｯ 閨02080ｹ ｧ90ｷ3046ｧ ｹ fi ｸ707 02fi fi apple6ｧ9apple00. ﾇ ｷ ｹ0 apple ｧ ｹ ｧ9ｨB ｸ700apple ｧ ｹ ｧ9000ｷ ｹ0, fiapple0ｷ30ｹ apple ｸ ｸ , fi applefi apple0ｸ fi. 6ｾ40ｸ70700apple060ｹ0, ｧ80ｹ0, 閨 apple 閨 ｸ ｧ9-55

8 13 ﾒ. ｦ ﾆ ﾞ036ﾑ8ｦ O08 ﾒ ﾞｦﾐ 6ｾ ﾑ ｧ o03o096ｧ9 18, ｸ7, 00apple ｧ ｧ8 0000apple ｧ apple006ｧ9 apple080ｸ ｦ0apple ｸ70407fi ｧ ｹ0 apple ｧ ｹ0. O 09096ｧ9000ｹ ｸ ｹ0 applefi ｧ8 6ﾑ ｧ ｸ8026ｧ80ｹ0 ﾒ ｹ0 (International Society for Peritoneal Dialysis) (ISPD) apple006ｧ ｹ0 apple ｧ ｹ ｧ90ｹ ｾ40209 ﾒ 6ｧ fi0706. 縺06 apple ｦ ｷ3036ｧ 閨 , 1993, 1996, ,13,14. 6ｾ 閨030ｷ ｸ , 09 ISPD 040ｸ ｷ30ｹ0 0000apple ｧ apple006ｧ ｧ apple08-036ｧ907090ｹ0 apple ｹ ｹ0 (cefazolin), 07026ｧ ｹ0 apple ｦ ｸ ｹ0 vancomycin, 00 ｨB6ｧ ｸ ｧ ｾ 閨030ｷ ｸ7 2000, 09 ISPD 040ｸ ｧ9ｨB ｸ ｧ apple08036ｧ907090ｹ0 apple ｹ ｹ0, apple08080ｸ7096ｧ ｸ703096ｧ9 0ｹ Gram ｧ90ｷ vancomycin, ｧ90ｹ apple ｷ3096ｧ8 086ｦ0030ｷ307 >100 ml/0900 閨 ｸ ｧ ceftazidime 14. ﾇ ｧ ｧ ｸ7-046ｧ9 fi ｸ ｧ apple ｦ ｧ apple 閨030ｷ ｷ ｹ0 0ｸ7apple ｧ80ｹ ｧ80ｹ ｸ703096ｧ9 0ｹ0. ﾇ ｸ702 6ｧ 閨030ｷ ｸ ｸ7apple6ｧ apple fi ｦ ﾇ 00apple ｧ ｹ0 0000apple ｧ80ｹ apple006ｧ9 0ｹ0 03 apple03 鐶pple ｧ fi 02080ｸ ｦ00ｹ ｸ7 02 閨 ｸ7, fi ｧ9 080ｹ0 020ｷ ｧ90ｷ ｸ ｧ ｸ70ｹ ｦ 08 apple030ｷ302fi apple03 鐶pple ｦ0apple fi03 02 Gram Gram apple fi07, apple080ｸ7 apple ｧ apple 03fi apple fi- ｨB ｹ0 0208apple0602 閨0ｹ0 040ｸ707036ｧ802000ｹ0. 030ｹ ｦ002080ｸ7, 09 ISPD 040ｸ apple ｧ8 0000apple ｧ80ｹ apple006ｧ9 0ｹ ｧ80ｹ 閨 ｧ80409 cefazolin 6ｧ8 vancomycin 0000 ceftazidime 6ｧ ｸ ｧ 閨 閨04080ｸ707 0ｸ 閨0ｹ 閨0ｹ0 MRS ｸ70700apple060ｹ apple ｦ apple08066ｧ804080ｸ vancomycin ｸ ｷ307 Gram 閨07 006ｦ fi Gram ｧ ﾇ 04036ｧ ｹ0 cefazolin apple ｸ ｸ ｷ307 Gram ｧ90ｷ307, 0ｷ30ｹ ｧ apple006ｧ9, 03 00apple ｦ ｧ ｧ8 00apple ｧ8, 03fi090ｷ ｸ ｦ0 apple ｦ0 020ｷ307 MRS fi 00 0ｹ0 02 閨 , ｦ ｧ ｧ fi ﾇ 00apple ｧ apple ｦ ｸ703006ｧ9 applefi fi0ｹ0 fi ｧ ｸ 閨0ｹ 閨03080ｸ707 00apple06020ｸ7046ｧ apple006ｧ ｹ0 apple ｧ ｹ0 apple080ｸ7 apple ｧ applefi MRS 0000 cefazolin, 03fi090ｷ ｹ0 0ｸ ｧ80ｹ0 040ｸ70902 閨 ｷ304090ｹ ｸ ｸ apple ｸ802fi 0ｸ70903fi 15. 6ｾ ｧ fi000ｷ30ｹ 閨070203, ｦ apple ｸ704076ｧ ｧ9 apple ｧ ｹ ｸ70ｹ ｧ90ｹ0 00 0ｹ ｾ40209 ﾒ, ｸ70ｹ0 CoNS, 006ｧ fi ｾ40ｸ70700apple060ｹ0, 09 00apple ｧ8 vancomycin 07026ｧ9 cefazolin 0ｷ30ｹ0 00 閨03080ｹ ｸ ｦ0 0000apple ｦ ｧ ｹ0 006ｧ apple03 閨 ｸ ｷ307 Gram , 06fi0206 0ｷ30ｹ ｷ30402fi apple08036ｧ ｹ ｧ 閨0ｹ0 閨 ｷ fi02020ｷ307. ﾇ fi07 076ｦ0apple ｧ8 020ｷ307 Gram ｧ90ｷ ｹ apple08036ｧ907000ｹ ｧ902090ｹ ｹ0, fi0ｹ0 applefi 閨0409 Acinetobacter baumanii 閨 閨 ｹ0 Stenotrophomonas maltophilia, 08 6ｧ apple ｧ ｹ0 ceftazidime 0ｷ30ｹ ｸ fi ｸ ｦ ｸ ｷ307 Gram , 040ｸ700apple 閨07090ｹ ｹ0 P. aeruginosa. 6ﾑ ｹ0 ceftazidime 006ｧ aztreonam ( ｸ7apple ｸ 閨07 ) 6ｧ8 09 cefepime, ｧ80ｹ apple ｧ ｸ ｧ ｧ fi ｸ7apple apple ｧ8 applefi fi ｧ ｸ ｧ apple ｧ80ｹ ｸ7apple ｧ ｧ ｸ703096ｧ9 16. ﾇ ｧ ｸ ｦ fi ｧ ｧ ｧ80ｹ0, ｧ apple ｧ ｸ ｷ307 Gram ｧ90ｷ 閨0709 6ｧ8 00apple fi apple006ｧ ｸ ｧ9 000ｹ ｸ , ｸ7apple ｧ8 036ｦ ｾ40ｸ700apple , 02 apple 閨 ｹ0 006ｧ ｸ ｧ80ｹ0: ) 6ﾑ8apple ｧ ｹ ｹ ｧ80ｹ0 0000apple ｧ80ｹ apple006ｧ9 0ｹ0 03 apple03 鐶pple ｧ ｧ 閨 , ｨBfi ｧ ｷ ｧ90ｷ307 apple080ｸ7 apple ｦ apple apple ｧ apple ｸ ｧ9 0ｹ ｸ70ｹ ) 閨 ｹ0 apple0804fi ｹ0 apple ｸ802086ｦ0 0ｸ ｦ0, 0208 apple fi 02090ｹ0 apple ｧ ｹ ｧ 閨 apple 閨 ｸ fi, fi ｸ ｸ7 apple ｦ ｧ9080ｸ7. 09) ﾇ 00026ｧ ｧ ｹ0 apple ｧ ｹ0 apple 閨 ｸ fi applefi apple ｧ8. ) ｦ Gram ｧ80306, 0ｷ30ｹ0 6ｧ90206 apple ｧ ｹ ｧ90ｹ0 0ｸ7applefi 6ｾ40209 ﾒ, apple ｦ007 2, 閨0ｹ0 040ｸ70407fi applefi 02 Gram ) O06 CoNS ｸ703086ｦ applefi 02080ｸ70ｹ fi ｸ70ｹ0 006ｧ apple03 閨 ｸ ｧ90206 apple ｧ ｹ ) ﾇ apple0800fi070ｷ30409 apple fi ｷ ｸ7 0007fi0ｹ ｧ90ｷ307 apple ｧ ｸ7036ｧ8 閨 ｸ apple 03086ｦ00ｹ0 apple ｧ ｹ ｧ90ｹ0 0ｸ7applefi 6ｾ40209 ﾒ. ｨB) ﾇ ｧ8 0000apple ｧ ｧ ｸ7 040ｸ707 0ｸ ｦ0 vancomycin + ceftazidime, ｨBfi ｸ70407fi apple0800fi070ｷ304090ｹ0 020ｷ ｸ ｧ ｸ70ｹ , ｦ0apple apple fi ｦ003080ｹ0 020ｷ307 56

9 136ﾑ ｧ ｧ9 18, ﾑ806ｦﾐｦ O03ｦﾐｦ ｦﾐ04 ﾞ 6ｾ46ﾑ8 ﾞ6ｾ4056ﾑ8036ﾑ8ｦﾐ6ｾ4 0809O 6ｾ408036ﾑ801 ﾇ 02O06 ﾇｦ ﾇ 096ﾑ806ｦﾐｦ O03 ﾞ07 ﾒ ﾇ ﾒ ﾞ05 ﾞ066ｾ4 ﾇ ( ) 06026ｧ90ｷ ｹ0 apple ｧ ｹ ｧ90ｹ0 0ｸ7applefi 6ｾ40209 ﾒ fi ｦ 006ｧ ｸ ｧ9080ｸ7 00 0ｹ0. Summary K. Tzanetou, N. Afentakis, V. Antonopoulou, A. Kapogli, P. Vamvakari, G. Moustakas, G. Tsoufakis, P. Ziroyiannis, E. Malamou-Lada. Peritonitis in CAPD patients: incidence, microbiology and susceptibility patterns of the causative organisms in one center. ﾇellen Nephrol 2006; 18 (1): Aim: a) To study the causative organisms of peritonitis in CAPD patients, the frequency of isolation and the susceptibility patterns to antimicrobial agents. b) To select the most appropriate initial empirical antibiotic treatment and c) ｦ o evaluate the incidence of peritonitis (episodes per patient per year). PatientsｨCMethods: We retrospectively evaluated all the cases of CAPD peritonitis from January 2001 throughout December All the cloudy peritoneal fluids with >100 leukocytes/00l were cultured for aerobic and anaerobic bacteria and fungi. The sediment obtained after centrifugation of 100 ml fluid was inoculated into BacTAlert (BacTAlert system, Bio Merieux, France) or BacTec (Becton Dickinson, Meylan Cedex, France) bottles and on solid culture media. The isolates were identified by API 20 E, API 20 NE, API STAPH, API STREP, Coryne API and VITEK-2 (bio Merieux Vitek two, France). Antibiotic susceptibility testing was performed by the disc diffusion technique on Mueller-Hinton agar, the VITEK-2 system and the Etest (AB Biodisk, Solna, Sweden). Results: During the study period, 92 episodes of peritonitis, 74 (80.43%) culture-positive and 18 (19.57%) culture-negative occurred in 42 patients. The noninfectious eosinophilic peritonitis (peritoneal fluid eosinophilia) was excluded from the culturenegative CAPD peritonitis. Among the 74 episodes, as a single cause of peritonitis, Gram-positive, Gramnegative bacteria, and Candida spp were isolated in 51 (68.92%), 19 (25.68%), and 2 (2.70%) cases respectively. Two (2.70%) episodes of mixed infection with more than one enteric pathogens (Enterococcus, E. coli) were caused from intestinal perforation. The coagulase-negative staphylococci (CoNS) and Enterococci were isolated in 28 (37.84%) and 11 (16.21%) cases respectively. Other Gram-positive bacteria Corynebacterium spp, Bacillus spp, and S. aureus were isolated in small proportions 5.41%, 5.41% and 2.70% respectively. Only one episode (1.35%) of anaerobic peritonitis from Clostridium histolyticum was identified. Proteus mirabilis (5.41%) and Pseudomonas aeruginosa (4.05%) were identified as the most common single cause of peritonitis from Gram-negative bacteria. The annual peritonitis rate (episodes/ patient-year) ranged from 1.3 to 1.7. The susceptibility testing showed a low resistance rate (17.85%) of CoNS to methicillin (MRS) and susceptibility of all Enterococci to vancomycin. A high proportion (50%) of Enterococci was highly resistant to gentamicin. All Gram-negative bacteria were multi-susceptible except for 2 nosocomial isolates of Acinetobacter baumannii. Conclusions: a) Gram-positive bacteria as causative agents of CAPD peritonitis occur 2.5 times more often than Gram-negative. b) CoNS followed by Enterococci are the most common causes of CAPD peritonitis. c) The isolation of more than one enteric pathogen is a strong evidence of secondary peritonitis in CAPD patients. d) Despite the culture of a large volume of peritoneal fluid the rate of culture-negative peritonitis remains high. e) The empirical use of vancomycin+ceftazidime, based on the frequency of the bacteria species isolation and their susceptibility to antibiotics, effectively cover all the range of the causative organisms in our Nephrology department. f) Selection of empiric therapy should be center specific and adapted to the local CAPD epidemiology. Key words: continuous ambulatory peritoneal dialysis, culture of peritoneal fluid, eosinophilic peritonitis, peritonitis. ｦﾌ ｧ9 1. Males BM, Walshe JJ, Amsterdam D. Laboratory indices of clinical peritonitis: total leukocyte count, microscopy, and microbiologic culture of peritoneal dialysis effluent. J Clin Microbiol 1987; 25: Ejaz AA, Fitzpatrick PM, Durkin AJ, et al. Pathophysiology of peritoneal fluid eosinophilia in peritoneal dialysis patients. Nephron 1999; 81: Isenberg HD. Culture of continuous ambulatory peritoneal dialysis fluid. In: Isenberg HD, ed. Essential Pro- -cedures for Clinical Microbiology. Washington DC: ASM Press; 1998: Van Biesen W, Vanholder R, Vogelaers D, et al. The need for a center-tailored treatment protocol for peritonitis. Perit Dial Int 1998; 18: Von Graevenitz A, Amsterdam D. Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis. Clin Microbiol Rev 1992; 5: Gloor HJ, Pandolfi S, Rｨｹttimann S. 20 years of peritoneal dialysis in a mid-sized Swiss hospital. Swiss Med Wkly 2003; 133: Zelenitsky S, Barns L, Findlay I, et al. Analysis of microbiological trends in peritoneal dialysis-related peritonitis from 1991 to Am J Kidney Dis 2000; 36: Tacconelli E, Carmeli Y, Aizer A, et al. Mupirocin prophylaxis to prevent Staphylococcus aureus infection in patients undergoing dialysis: a meta-analysis. Clin 57

10 13 ﾒ. ｦ ﾆ ﾞ036ﾑ8ｦ O08 ﾒ ﾞｦﾐ 6ｾ ﾑ ｧ o03o096ｧ9 18, 2006 Infect Dis 2003; 37: Sewell DL, Golper TA, Hulman PB, et al. Comparison of large volume culture to other methods for isolation of microorganisms from dialysate. Perit Dial Int 1990; 10: Alfa MJ, Degagne P, Olson N, et al. Improved detection of bacterial growth in continuous ambulatory peritoneal dialysis effluent by use of BacT/Alert FAN bottles. J Clin Microbiol 1997; 35: Piraino B, Bailie GR, Bernardini J, et al. ISPD Ad Hoc Advisory Committee. Peritoneal dialysis-related infections recommendations: 2005 update. Perit Dial Int. 2005; 25: Tzanetou K, Triantaphillis G, Tsoutsos D, et al. Stenotrophomonas maltophilia peritonitis in CAPD patients: susceptibility to antibiotics and treatment outcome: a report of five cases. Perit Dial Int 2004; 24: Keane WF, Alexander SR, Bailie GR, et al. Peritoneal dialysis-related peritonitis treatment recommendations: 1996 update. Perit Dial Int 1996; 16: Keane WF, Bailie GR, Boeschoten E, et al. International Society for Peritoneal Dialysis. Adult peritoneal dialysis-related peritonitis treatment recommendations: 2000 update. Perit Dial Int 2000; 20: Ariano RE, Franczuk C, Fine A, et al. Challenging the current treatment paradigm for methicillin-resistant Staphylococcus epidermidis peritonitis in peritoneal dialysis patients. Perit Dial Int 2002; 22: Baker RJ, Senior H, Clemenger M, Brown EA. Empirical aminoglycosides for peritonitis do not affect residual renal function. Am J Kidney Dis 2003; 41: A o ｧ9 : ﾒ. ｦ ｨB 07 閨02080ｸ fi 6ﾑ ｧ 縺03 ﾞ 00. 縺 ｹ , ﾞ036ｧ807 T0903: , 3 Fax: ktzane@otenet.gr 58