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
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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