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Impact of multiple drug-resistant Gram-negative bacterial bacteraemia on infected pancreatic necrosis patients

Di Wu1,2, Yan Jia1, Wenhao Cai2,3

  • 1Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, China.

Frontiers in Cellular and Infection Microbiology
|December 12, 2022
PubMed
Abstract

Insights

Multiple drug-resistant Gram-negative bacterial (MDR-GNB) infections significantly increase mortality in infected pancreatic necrosis (IPN) patients. This risk is even higher for patients with severe acute pancreatitis and MDR-GNB bacteraemia.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Gastroenterology

Background:

  • Multiple drug-resistant Gram-negative bacterial (MDR-GNB) bacteraemia presents a critical challenge in hospital settings.
  • Infected pancreatic necrosis (IPN) patients are particularly susceptible to severe infectious complications.
  • Understanding the impact of MDR-GNB bacteraemia on IPN patient outcomes is crucial for improving care.

Purpose of the Study:

  • To evaluate the impact of MDR-GNB bacteraemia on mortality rates in patients with infected pancreatic necrosis (IPN).
  • To identify independent predictors of mortality in IPN patients, considering the presence of MDR-GNB bacteraemia and acute pancreatitis severity.

Main Methods:

  • A case-control study was conducted in a Chinese tertiary teaching hospital from January 2016 to July 2022.
  • IPN patients with MDR-GNB bacteraemia were compared to a control group without MDR-GNB bacteraemia (1:2 ratio).
  • Univariate and multivariate logistic regression analyses were used to identify predictors of overall mortality.

Main Results:

  • MDR-GNB bacteraemia was associated with a significantly higher mortality rate (62.5% vs. 8.3%, p < 0.001).
  • Severe acute pancreatitis (AP) combined with MDR-GNB bacteraemia further elevated mortality to 81.3% (p = 0.025).
  • MDR-GNB bacteraemia (OR=8.976) and severe AP (OR=9.414) were independent predictors of mortality. MDR-Klebsiella pneumoniae was the most common pathogen.

Conclusions:

  • MDR-GNB bacteraemia substantially increases mortality in IPN patients.
  • The combination of severe AP and MDR-GNB bacteraemia leads to a particularly high mortality risk.
  • Prompt identification and management of MDR-GNB infections are vital for improving outcomes in IPN patients.
Keywords:
Gram-negative bacterial bacteraemiaacute pancreatitisinfected pancreatic necrosismortalitymultiple drug-resistant

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