Risk Factors and Outcomes of Multidrug-Resistant Bacteria Infection in Infected Pancreatic Necrosis Patients

Area of Science:

• Infectious Diseases
• Gastroenterology
• Critical Care Medicine

Background:

• Acute pancreatitis (AP) incidence is rising, with a significant portion developing necrotizing pancreatitis (NP).
• Infected pancreatic necrosis (IPN) presents a high risk of fatal infectious complications, often treated with antibiotics.
• Prolonged antibiotic use in IPN can lead to multidrug-resistant bacteria (MDRB) infections, increasing mortality.

Purpose of the Study:

• To determine the incidence of MDRB infection in IPN patients.
• To identify independent risk factors associated with MDRB infection in IPN patients.
• To characterize common infectious strains in IPN patients.

Main Methods:

• Retrospective analysis of clinical data from 267 IPN patients treated between 2014 and 2021.
• Patients were categorized into MDRB infection (n=124) and non-MDRB infection (n=143) groups.
• Multivariable analysis was employed to identify independent risk factors.

Main Results:

• MDRB group showed higher CTSI scores, pancreatic necrosis degree, and PCT levels on admission.
• Common MDRB included Acinetobacter baumannii (gram-negative), Enterococcus faecium (gram-positive), and Candida albicans (fungal).
• Independent risk factors for MDRB infection were complications of EPI (OR: 4.116), PCT level (OR: 2.728), and pancreatic necrosis degree (OR: 2.741).

Conclusions:

• This study identified common infectious strains and significant risk factors for MDRB infection in IPN patients.
• Early identification of risk factors like elevated PCT and pancreatic necrosis degree is crucial for managing MDRB infections.
• Findings can inform strategies to mitigate MDRB development and improve outcomes in IPN patients.