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Characteristics of and risk factors for biliary pathogen infection in patients with acute pancreatitis
Shayan Chen1,2, Jiyu Shi3, Minghui Chen1
1Department of Laboratory Science, Tianjin Medical University NanKai Hospital, Tianjin, 300100, China.
Background:
Infection in patients with acute pancreatitis, especially severe acute pancreatitis patients, is a common and important phenomenon, and the distributions and drug resistance profiles of bacteria causing biliary infection and related risk factors are dynamic. We conducted this study to explore the characteristics of and risk factors for bacterial infection in the biliary tract to understand antimicrobial susceptibility, promote the rational use of antibiotics, control multidrug-resistant bacterial infections and provide guidance for the treatment of acute pancreatitis caused by drug-resistant bacteria.
Methods:
The distribution of 132 strains of biliary pathogenic bacteria in patients with acute pancreatitis from January 2016 to December 2020 were analyzed. We assessed drug resistance in the dominant Gram-negative bacteria and studied the drug resistance profiles of multidrug-resistant bacteria by classifying Enterobacteriaceae and nonfermentative bacteria. We then retrospectively analyzed the clinical data and risk factors associated with 72 strains of Gram-negative bacilli, which were divided into multidrug-resistant bacteria (50 cases) and non-multidrug-resistant bacteria (22 cases).
Results:
The main bacteria were Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli had a 66.67% detection rate. Acinetobacter baumannii had more than 50.00% drug resistance to carbapenems, ESBL-producing Klebsiella pneumoniae had 100.00% drug resistance, and Pseudomonas aeruginosa had 66.67% resistance to carbapenems. Multivariate logistic regression analysis suggested that the administration of third- or fourth-generation cephalosporins was an independent risk factor for Gram-negative multidrug-resistant biliary bacterial infection in acute pancreatitis patients.
Conclusion:
Drug resistance among biliary pathogens in acute pancreatitis patients remains high; therefore, rational antimicrobial drug use and control measures should be carried out considering associated risk factors to improve diagnosis and treatment quality in acute pancreatitis patients.
Insights
Biliary bacterial infections in acute pancreatitis show high drug resistance, particularly from multidrug-resistant organisms. Prior cephalosporin use is a key risk factor, necessitating rational antibiotic strategies.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Clinical Microbiology
Background:
- Biliary tract infections are common in acute pancreatitis, especially severe cases.
- Understanding bacterial distribution and antimicrobial resistance is crucial for effective treatment.
- Dynamic changes in resistance patterns necessitate ongoing surveillance.
Purpose of the Study:
- To investigate the characteristics and risk factors of biliary tract bacterial infections in acute pancreatitis patients.
- To analyze antimicrobial susceptibility patterns of common pathogens.
- To guide rational antibiotic use and control multidrug-resistant infections.
Main Methods:
- Analysis of 132 biliary pathogenic bacterial strains from acute pancreatitis patients (2016-2020).
- Assessment of drug resistance in dominant Gram-negative bacteria, including Enterobacteriaceae and nonfermentative bacteria.
- Retrospective analysis of clinical data for 72 Gram-negative bacilli strains to identify risk factors for multidrug resistance.
Main Results:
- Key pathogens included Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa.
- High resistance rates observed: ESBL-producing E. coli (66.67%), A. baumannii to carbapenems (>50%), ESBL-producing K. pneumoniae (100%), P. aeruginosa to carbapenems (66.67%).
- Third- or fourth-generation cephalosporin administration was an independent risk factor for multidrug-resistant Gram-negative biliary infection.
Conclusions:
- High drug resistance among biliary pathogens in acute pancreatitis patients persists.
- Rational antimicrobial drug use and control measures are essential.
- Considering associated risk factors can improve diagnosis and treatment quality for acute pancreatitis.
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