Abstract
BackgroundInfection 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.MethodsThe 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).ResultsThe 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.ConclusionDrug 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.
Highlights
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
General characteristics of the distributions and proportions of bile pathogenic bacteria A total of 120 positive cases were diagnosed and 132 pathogenic bacterial strains were isolated from 560 bile samples from acute pancreatitis (AP) patients
Seventy-two Gram-negative bacterial strains accounted for 54.55% of the isolates, 56 Gram-positive bacterial strains accounted for 42.42% of the isolates, and 4 fungi accounted for only 3.03% of the isolates
Summary
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. Biliary infection in acute pancreatitis (AP) patients, especially severe acute pancreatitis (SAP) patients, is common and has been associated with invasive clinical procedures, septicemia, intestinal barrier dysfunction and gut bacteria translocation [1]. It remains an important cause of death in patients with SAP [2]; for. With the extensive use of antibiotics for the treatment of bacterial infections, MDROs have become common and important pathogens responsible for nosocomial infections, resulting in an intractable challenge for clinical diagnosis and treatment [6]; it is necessary to clarify the risk factors for MDRO infection in AP patients
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