Copyright
©The Author(s) 2019.
World J Gastroenterol. Sep 14, 2019; 25(34): 5162-5173
Published online Sep 14, 2019. doi: 10.3748/wjg.v25.i34.5162
Published online Sep 14, 2019. doi: 10.3748/wjg.v25.i34.5162
Table 1 Comparison of baseline demographic and clinical characteristics between the infection group and non-infection group
Variable | Total (n = 205) | Infection (n = 163) | Non-infection (n = 42) | P-value |
Age (yr) | 49.5 ± 15.7 | 50.3 ± 15.5 | 46.6 ± 16.7 | 0.173 |
Male | 140 | 112 | 28 | 0.801 |
Etiology | 0.898 | |||
Biliary | 109 | 88 | 21 | |
Alcohol | 10 | 7 | 3 | |
Hyperlipemia | 67 | 52 | 15 | |
ERCP | 6 | 5 | 1 | |
Others | 13 | 11 | 2 | |
Referral time | 24 (0-300) | 30 (0-300) | 2.5 (0-180) | 0.013a |
CTSI | 4 (2-10) | 6 (2-10) | 4 (2-8) | 0.127 |
Persistent OF | 50 | 49 | 1 | 0.005b |
Need for any intervention | 120 | 113 | 7 | < 0.001c |
Death | 20 | 18 | 2 | 0.191 |
TPN | 17 (0-163) | 18 (0-163) | 10 (0-47) | < 0.001c |
EN | 1 (0-112) | 2 (0-112) | 0 (0-34) | 0.004b |
Length of hospital stay(d) | 29 (0-172) | 32 (0-172) | 19 (5-48) | < 0.001c |
Length of stay ICU stay | 11 (0-117) | 13 (0-28) | 7 (0-117) | 0.004b |
Necrosis degree | 0.018a | |||
< 30% | 40 | 26 | 14 | |
30%-50% | 80 | 65 | 15 | |
> 50% | 85 | 72 | 13 |
Table 2 Microbiological profile of organisms in infected patients
Organism | INP (n = 212) | Extrapancreatic infection (n = 327) |
Gram-negative | ||
P. aeruginosa | 34 | 32 |
A. baumanii | 22 | 22 |
E. coli | 34 | 20 |
K. pneumoniae | 30 | 16 |
Gram-positive | ||
S. epidermidis | 5 | 32 |
E. faecium | 18 | 30 |
S. haemolyticus | 5 | 19 |
S. aureus | 5 | 8 |
Fungal | ||
C. albicans | 3 | 19 |
C. parapsilosis | 0 | 12 |
C. tropicalis | 0 | 12 |
C. glabrata | 1 | 9 |
Table 3 Drug sensitivity of Gram-negative bacteria in infected patients
Pancreatic | Extrapancreatic | |||||||
Antibiotic | P. aeruginosa | E. coli | A. baumannii | K. pneumoniae | P. aeruginosa | E. coli | A. baumannii | K. pneumoniae |
MDR bacteria | 9/34 | 9/34 | 16/22 | 15/30 | 8/32 | 4/20 | 17/22 | 11/16 |
ESBL +: | — | 14/34 | — | 6/30 | — | 10/20 | — | 2/16 |
Penicillins | ||||||||
Ampicillin | 0/34 | 8/34 | 0/22 | 1/30 | 0/32 | 4/20 | 1/22 | 0/16 |
Piperacillin | 12/34 | 4/34 | 0/22 | 3/30 | 14/32 | 4/20 | 1/22 | 0/16 |
Enzymatic penicillins | ||||||||
Piperacillin/tazobactam | 13/34 | 10/34 | 4/22 | 8/30 | 19/32 | 11/20 | 1/22 | 4/16 |
Cefoperazone/sulbactam | 8/34 | 0/34 | 4/22 | 0/30 | 9/32 | 0/20 | 4/22 | 0/16 |
Ampicillin/sulbactam | 0/34 | 4/34 | 0/22 | 4/30 | 0/32 | 6/20 | 4/22 | 0/16 |
quinolones | ||||||||
Levofloxacin | 21/34 | 11/34 | 3/22 | 11/30 | 17/32 | 6/20 | 3/22 | 3/16 |
First- and second-generation cephalosporins | ||||||||
Cefoxitin | 0/34 | 0/34 | 0/22 | 0/30 | 0/32 | 0/20 | 0/22 | 0/16 |
Cefuroxime | 0/34 | 0/34 | 0/22 | 0/30 | 0/32 | 0/20 | 0/22 | 0/16 |
Third- and fourth-generation cephalosporins | ||||||||
Ceftazidime | 14/34 | 13/34 | 3/22 | 7/30 | 16/32 | 11/20 | 3/22 | 2/16 |
Cefepime | 17/34 | 12/34 | 3/22 | 10/30 | 15/32 | 11/20 | 3/22 | 3/16 |
Carbapenems | ||||||||
Imipenem | 10/34 | 21/34 | 2/22 | 11/30 | 10/32 | 12/20 | 3/22 | 2/16 |
Meropenem | 10/34 | 11/34 | 3/22 | 6/30 | 9/32 | 6/20 | 3/22 | 2/16 |
Sulfonamides | ||||||||
Compound trimethoprim | 1/34 | 14/34 | 9/22 | 14/30 | 0/32 | 10/20 | 8/22 | 9/16 |
Tetracycline | ||||||||
Tigecycline | 1/34 | 1/34 | 17/22 | 13/30 | 0/32 | 2/20 | 18/22 | 9/16 |
Minocycline | — | — | 9/22 | — | 0/32 | — | 10/22 | — |
Table 4 Drug sensitivity of Gram-positive bacteria in infected patients
Pancreatic | Extrapancreatic | |||||||
Antibiotic | E. faecium | S. epidermidis | S. aureus | E. faecalis | E. faecium | S. epidermidis | S. aureus | E. faecalis |
MDR bacteria | 5/18 | 0/5 | 2/5 | 3/6 | 4/30 | 1/32 | 3/8 | 0/5 |
ESBL +: | — | 3/5 | 3/5 | — | — | 12/32 | 3/8 | — |
Penicillins | ||||||||
Ampicillin | 2/18 | 0/5 | 0/5 | 3/6 | 1/30 | 0/32 | 0/8 | 3/5 |
Penicillin G | 0/18 | 0/5 | 0/5 | 1/6 | 0/30 | 0/32 | 0/8 | 3/5 |
quinolones | ||||||||
Ciprofloxacin | 1/18 | 0/5 | 0/5 | 1/6 | 0/30 | 8/32 | 3/8 | 3/5 |
Levofloxacin | 2/18 | 0/5 | 0/5 | 1/6 | 1/30 | 8/32 | 3/8 | 3/5 |
Moxifloxacin | 1/18 | 2/5 | 0/5 | 1/6 | 1/30 | 21/32 | 3/8 | 3/5 |
Macrolactones | ||||||||
Linezolid | 14/18 | 5/5 | 4/5 | 5/6 | 25/30 | 31/32 | 8/8 | 4/5 |
Tetracycline | ||||||||
Tigecycline | 17/18 | 5/5 | 5/5 | 5/6 | 27/30 | 32/32 | 8/8 | 5/5 |
Sulfonamides | ||||||||
Compound trimethoprim | 1/18 | 1/5 | 4/5 | 0/6 | 2/30 | 9/32 | 6/8 | 2/5 |
Polypeptides | ||||||||
Vancomycin | 11/18 | 5/5 | 5/5 | 6/6 | 25/30 | 31/32 | 8/8 | 5/5 |
Table 5 Multivariable analysis for independent predictors of mortality
Variable | Univariable analysis | P-value | Multivariable analysis | P-value |
OR (95%CI) | OR (95%CI) | |||
Persistent OF | 5.37 (3.785-7.618) | < 0.001 | 0.012 (0.001-0.101) | < 0.001c |
MDR organism (s) | 2.445 (1.554-3.848) | 0.001 | 0.134 (0.028-0.633) | 0.011b |
Fungal infection | 2.719 (1.498-4.936) | 0.002 | 0.657 (0.156-2.770) | 0.567 |
Prophylactic antibiotic | 0.974 (0.783-1.210) | 0.8 | 0.534 (0.095-2.989) | 0.475 |
INP | 1.151 (0.802-1.651) | 0.48 | 0.277 (0.024-3.234) | 0.306 |
Extrapancreatic infection | 1.383 (1.124-1.704) | 0.031 | 0.627 (0.042-9.273) | 0.734 |
Referred patients | 1.102 (0.986-1.232) | 0.25 | 0.524 (0.041-6.655) | 0.619 |
Operation | 0.789 (0.497-1.255) | 0.262 | 10.533 (1.052-105.491) | 0.045a |
Complication | 2.921 (1.304-6.540) | 0.011 | 0.892 (0.191-4.162) | 0.885 |
- Citation: Lu JD, Cao F, Ding YX, Wu YD, Guo YL, Li F. Timing, distribution, and microbiology of infectious complications after necrotizing pancreatitis. World J Gastroenterol 2019; 25(34): 5162-5173
- URL: https://www.wjgnet.com/1007-9327/full/v25/i34/5162.htm
- DOI: https://dx.doi.org/10.3748/wjg.v25.i34.5162