Timing, distribution, and microbiology of infectious complications after necrotizing pancreatitis
Autor: | Yu-Duo Wu, Yulin Guo, Fei Li, Jiong-Di Lu, Feng Cao, Yi-Xuan Ding |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.drug_class Drug sensitivity test Antibiotics Bacteremia Microbial Sensitivity Tests Tigecycline medicine.disease_cause Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Retrospective Study Drug Resistance Multiple Bacterial Extrapancreatic infection Internal medicine medicine Humans Respiratory Tract Infections Aged Retrospective Studies Bacteria Coinfection Pancreatitis Acute Necrotizing business.industry Necrotizing pancreatitis Pathogenic bacteria General Medicine Middle Aged Prognosis medicine.disease Anti-Bacterial Agents Treatment Outcome chemistry 030220 oncology & carcinogenesis Linezolid Pancreatic Infection Acute pancreatitis Vancomycin Female 030211 gastroenterology & hepatology business medicine.drug |
Zdroj: | World Journal of Gastroenterology |
ISSN: | 1007-9327 |
Popis: | BACKGROUND Acute pancreatitis (AP) is a common acute abdominal disease worldwide, and its incidence rate has increased annually. Approximately 20% of AP patients develop into necrotizing pancreatitis (NP), and 40% to 70% of NP patients have infectious complications, which usually indicate a worse prognosis. Infection is an important sign of complications in NP patients. AIM To investigate the difference in infection time, infection site, and infectious strain in NP patients with infectious complications. METHODS The clinical data of AP patients visiting the Department of General Surgery of Xuanwu Hospital of Capital Medical University from January 1, 2014 to December 31, 2018 were collected retrospectively. Enhanced computerized tomography or magnetic resonance imaging findings in patients with NP were included in the study. Statistical analysis of infectious bacteria, infection site, and infection time in NP patients with infectious complications was performed, because knowledge about pathogens and their antibiotic susceptibility patterns is essential for selecting an appropriate antibiotic. In addition, the factors that might influence the prognosis of patients were analyzed. RESULTS In this study, 539 strains of pathogenic bacteria were isolated from 162 patients with NP infection, including 212 strains from pancreatic infections and 327 strains from extrapancreatic infections. Gram-negative bacteria were the main infectious species, the most common of which were Escherichia coli and Pseudomonas aeruginosa. The extrapancreatic infection time (9.1 ± 8.8 d) was earlier than the pancreatic infection time (13.9 ± 12.3 d). Among NP patients with early extrapancreatic infection (< 14 d), bacteremia (25.12%) and respiratory tract infection (21.26%) were predominant. Among NP patients with late extrapancreatic infection (> 14 d), bacteremia (15.94%), respiratory tract infection (7.74%), and urinary tract infection (7.71%) were predominant. Drug sensitivity analysis showed that P. aeruginosa was sensitive to enzymatic penicillins, third- and fourth-generation cephalosporins, and carbapenems. Acinetobacter baumannii and Klebsiella pneumoniae were sensitive only to tigecycline; Staphylococcus epidermidis and Enterococcus faecium were highly sensitive to linezolid, tigecycline, and vancomycin. CONCLUSION In this study, we identified the timing, the common species, and site of infection in patients with NP. |
Databáze: | OpenAIRE |
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