Pathogenic characteristics and risk factors analysis of secondary pancreatic infection in acute pancreatitis
CHEN Ming-hui,ZHANG Ai-min,ZENG Zhao-wei
Abstract:
Objective To analyze the pathogenic characteristics and risk factors of secondary pancreatic infection in patients with acute pancreatitis, and to provide a basis for clinical treatment and medication of such infections. Methods A total of 495 patients with acute pancreatitis admitted to Nankai Hospital in Tianjin from January 2022 to October 2024 were selected as the study subjects. Based on the occurrence of pancreatic infection, the patients were divided into an infected group (n=193) and a non-infected group (n=302). Data on patients' age, gender, etiology, underlying diseases, tracheal intubation, duration of abdominal drainage, and pathogen examination results were collected. Risk factors and pathogenic characteristics of pancreatic infection in patients with acute pancreatitis were analyzed. Results A total of 445 pathogenic strains were isolated from pancreatic drainage fluid cultures, including 209 Gram-negative bacteria, accounting for 46.97%; 227 Gram-positive bacteria, accounting for 51.01%; and 7 fungal strains, accounting for 1.57%. The resistance rate of Escherichia coli to ampicillin showed an increasing trend (P <0.05). The resistance rates of Klebsiella pneumoniae to amoxicillin/clavulanic acid, piperacillin/tazobactam, ceftazidime, doripenem, aztreonam, levofloxacin, and aminoglycoside antibiotics increased(P <0.05). The resistance rate of Enterococcus faecalis to ampicillin showed a fluctuating decline (P <0.05). Advanced age, tracheal intubation, concomitant respiratory failure, concomitant intra-abdominal hypertension, abdominal drainage duration>7 days, and concomitant sepsis were correlated with secondary pancreatic infection in patients with acute pancreatitis(P <0.05). Among these, tracheal intubation, concomitant intra-abdominal hypertension, abdominal drainage duration >7 days, and concomitant sepsis were identified as risk factors for secondary pancreatic infection in patients with acute pancreatitis (P <0.05). Conclusion The pathogens isolated from secondary pancreatic infections in acute pancreatitis are primarily Gram-negative bacilli and Gram-positive cocci, with continuously changing drug resistance patterns. Rational drug use should be guided by antimicrobial susceptibility testing results. Secondary pancreatic infection in patients is correlated with tracheal intubation, concomitant intra-abdominal hypertension, abdominal drainage duration >7 days, and concomitant sepsis. Clinical measures should be implemented to enhance infection prevention.
