Compositional and drug-resistance profiling of pathogens in patients with severe acute pancreatitis: a retrospective study

Abstract

Background: Infection is one of the important causes of death in patients with severe acute pancreatitis (SAP) , but the bacterial spectrum and antibiotic resistance are constantly changing. Making good use of antibiotics and controlling multi-drug-resistant (MDR) bacterial infections are of vital importance in improving the cure rate of SAP. We conducted a retrospective study in the hope of providing references for antibiotic selection and control of drug-resistant bacteria. Methods: Retrospective analysis was performed on the data of patients hospitalized in our hospital due to acute pancreatitis (AP) in the past 5 years. General data were classified and statistically analyzed. Subsequently, the bacterial spectrum characteristics and the data related to drug-resistant bacterial infection of 569 AP patients were analyzed. Finally, unconditional logistic regression analysis was conducted to analyze the risk factors of MDR infection. Results: A total of 398 patients were enrolled in this study and the hospitalization data and associated results were analyzed. A total of 461 strains of pathogenic bacteria were detected, including 223 (48.4%) gram-negative bacterial strains, 190 (41.2%) gram-positive bacterial strains and 48 (10.4%) fungal strains. The detection rates of resistance in gram-negative and gram-positive bacterial strains were 48.0% (107/223) and 25.3% (48/190), respectively. There were significant differences between the MDR group and the non-MDR group for the factors of precautionary antibiotic use, kinds of antibiotics used, receipt of carbapenem, tracheal intubation, hemofiltration and number of hospitalization days in the intensive care unit. Unconditional logistic regression revealed 2 risk factors for MDR bacterial infection. Conclusions: Our results illustrate that gram-negative bacteria were the most common pathogens in SAP infection, and the proportion of gram-positive bacteria increased notably. The rate of antibiotic resistance was higher than previously reported. Unconditional logistic regression analysis showed that using more types of antibiotics and the number of hospitalization days in the ICU were the risk factors associated with MDR bacterial infection.

Predictors of Mortality and Drug Resistance Among Carbapenem-Resistant Enterobacteriaceae-Infected Pancreatic Necrosis Patients

“…Overused prophylactic antibiotic treatments for 'suspected' IPN could result in the acquisition of MDR or carbapenem resistance [1]. Precious studies reported that CRE, as a mainly infectious MDR pathogen, has spread worldwide and influenced the outcome of IPN patients especially in India and China [7,[12][13][14][15][16].…”

“…Shenvi et al found that markers of inflammation may be helpful to determine the timing and choice of IPN therapeutic intervention [18]. Despite recent clinical research focused on MDR IPN among AP patients, there are still important knowledge gaps and a lack of accurate clinical data among the CRE IPN population [7,8,12].…”

Efficacy of Graded Emergency Nursing on Acute Pancreatitis Patients: A Meta-Analysis

“…Patients' pancreas will have various complications such as bleeding and necrosis, multiple organ failure, secondary infection, peritonitis and shock. The incidence is as high as 40%-70% (5), and the mortality is about 7%-47% (6,7). AP is a common disease in emergency department, which is dangerous and develops rapidly.…”