Title: PD-associated peritonitis
题目：与腹透相关的腹膜炎
Author 作者: Vikramjit Gill

Peritoneal dialysis (PD) is a commonly used form of dialysis for pediatric patients with end-stage renal disease, particularly in children less than five years of age.
腹部透析（PD）在治疗儿科晚期肾病中是常用的透析方法，尤其对于5岁以下的病人。
One well known complication to this mode of dialysis is PD-associated peritonitis.
这一形式透析的一个最为知的合并症是腹透相关的腹膜炎。
Children may present with fever, abdominal pain and a cloudy dialysate.
孩子表现有发烧，腹部疼痛，和浑浊透析液。
If peritonitis is suspected, obtain sample of dialysate fluid and send for cell count, Gram’s stain and culture.
如怀疑腹膜炎，采取透析液查细胞数，革兰氏染色和培养。
Cell count in PD-associated peritonitis is usually WBC >100 with >50% neutrophils.
细胞数在透析相关腹膜炎时，WBC超过100，中性粒细胞比例超过50％。
Both gram-positive and gram-negative organisms are involved with PD-associated peritonitis . Keep both MRSA and Pseudomonas in mind.
腹膜透析相关腹膜炎可由革兰氏阳性和阴性致病菌引起，要注意MRSA和绿浓杆菌感染。
In the ED, empiric therapy should cover both gram-positive and gram-negative organisms. Initiate antibiotic therapy with vancomycin and either a third-generation cephalosporin (ceftazidime) or aminoglycoside, respectively.
在急诊科，经验性治疗要针对革兰氏阳性和阴性菌，可开始用万古霉素和相应的一个三代头孢（头孢他啶）或氨基糖苷类。
For PD-associated peritonitis, intraperitoneal (IP) administration of antibiotics is preferred over IV.
对于腹透相关的腹膜炎，抗菌素腹腔内注射要优于静脉注射。
References参考文献

1. Li PK, et al. Peritoneal Dialysis-Related Infections Recommendations: 2010 Update. Peritoneal Dialysis International, Vol. 30, pp. 393–423.
2. Fadrowski JJ, et al. Children on long-term dialysis in the United States: findings from the 2005 ESRD clinical performance measures project. Am J Kidney Dis. 2007;50(6):958.