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Impact of invasive infections on clinical outcomes in acute pancreatitis: early predictive factors and implications for prophylactic anti-infective therapy

  • 0Department of General, Visceral, Thoracic and Transplant Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany. fabienne.bender@chiru.med.uni-giessen.de.
Gut Pathogens +

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January 19, 2025

|

January 19, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Pathogen detection in acute pancreatitis correlates with worse outcomes. Early indicators like ascites and high white blood cell count suggest invasive infection, warranting early anti-infective strategies.

Area Of Science

  • Gastroenterology
  • Infectious Diseases
  • Critical Care Medicine

Background

  • Antibiotic use in acute pancreatitis is debated, reserved for confirmed infections.
  • Reliable early predictors for septic complications are lacking.

Purpose Of The Study

  • To identify early predictors of septic complications in acute pancreatitis.
  • To evaluate the association between pathogen detection and clinical outcomes.

Main Methods

  • Retrospective review of 424 acute pancreatitis patients.
  • Propensity score matching to compare pathogen-positive (GERM(+)) and pathogen-negative (GERM(-)) groups.
  • Multivariate analysis to identify early predictors of pathogen detection.

Main Results

  • GERM(+) patients had significantly worse outcomes: higher ICU rates (59.5% vs. 35.0%), longer ICU stays (11.5 vs. 3.0 days), and longer hospitalizations (26.8 vs. 14.7 days).
  • Ascites and elevated white blood cell count at onset were significant predictors of invasive infection.
  • Common pathogens included gastrointestinal commensals.

Conclusions

  • Pathogen detection in acute pancreatitis is linked to unfavorable outcomes.
  • Ascites and elevated white blood cell count predict invasive infection risk.
  • Early anti-infective strategies against intestinal pathogens may improve outcomes.

Keywords:

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