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Infections in Acute Pancreatitis: Organisms, Resistance-Patterns and Effect on Mortality

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Abstract

Background

Acute pancreatitis (AP) is a common gastrointestinal disease in which infection is a serious complication. Understanding its bacterial spectrum and antibiotic resistance is of great significance for treatment.

Objective

This retrospective study analyzed the Medical Information Mart for Intensive Care database with the aim of identifying the distribution characteristics of pathogenic bacteria in AP patients.

Methods

First, 2089 AP patients were classified and analyzed statistically according to culture results. Second, the bacterial profile, antibiotic resistance, and antibiotic-use data of positive culture group were analyzed. Third, logistic regression analysis was used to identify the rick factors of culture results, and culture results correlations with mortality.

Results

This study included 1486 patients in negative culture group, 603 patients in positive cultures. Enterococcus spp. (71%), Enterococcus faecium (61%), and Staphylococcus aureus coagulase-positive (54%) exhibited the highest proportions of drug resistance. Logistic regression revealed five factors related to positive culture (the number of antibiotics, length of stay in hospital, length of stay in intensive care unit, mechanical ventilation, and parenteral nutrition) and four factors related to distribution of multidrug-resistant bacterial infection (age, hemoglobin, length of stay in hospital, and duration on antibiotics).

Conclusions

This study found that enteric bacteria were the most common source of infection (26.7%). Carbapenems, penicillins containing enzyme inhibitors, fifth-generation cephalosporins, oxazolidinones, and some of the aminoglycoside antibiotics had high sensitivity, which can guide the use of clinical empiric antibiotics. Positive culture was an independent risk factor for in-hospital all-cause mortality of AP patients.

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Funding

This study was supported by The National Natural Science Foundation of China (Grant Nos. 82072232, 81871585), Natural Science Foundation of Guangdong Province (Grant No. 2018A030313058), Technology and Innovation Commission of Guangzhou Science (Grant No. 2018A030313058), and Medical Scientific Research Foundation of Guangdong Province of China (Grant No. A2021176).

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Author notes

  1. Fang Li and Feng Zhang have been treated as co-first author.

Authors and Affiliations

  1. Department of Intensive Care Unit, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China

    Fang Li, Xueqin Wan, Kesong Wu & Qing Liu

  2. Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China

    Fang Li, Feng Zhang, Chuiyan Qiu & Haiyan Yin

  3. Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China

    Jun Lyu

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  1. Fang Li
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Correspondence to Haiyan Yin or Jun Lyu.

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Li, F., Zhang, F., Wan, X. et al. Infections in Acute Pancreatitis: Organisms, Resistance-Patterns and Effect on Mortality. Dig Dis Sci 68, 630–643 (2023). https://doi.org/10.1007/s10620-022-07793-1

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  • DOI: https://doi.org/10.1007/s10620-022-07793-1

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