Clinical Characteristics of Acute Pancreatitis Patients with Multidrug-Resistant Bacterial Infection

Guilan Cheng; Dingxi Wang; Ping Zhu; Ziqi Lin; Shichao Zhu; Juan Li; Linqian Li; Yipeng Zhang; Guixiang Li

doi:10.2147/IDR.S354347

Clinical Characteristics of Acute Pancreatitis Patients with Multidrug-Resistant Bacterial Infection

Infect Drug Resist. 2022 Mar 31:15:1439-1447. doi: 10.2147/IDR.S354347. eCollection 2022.

Authors

Guilan Cheng^#¹, Dingxi Wang^#¹, Ping Zhu², Ziqi Lin², Shichao Zhu³, Juan Li¹, Linqian Li¹, Yipeng Zhang⁴, Guixiang Li¹

Affiliations

¹ Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, People's Republic of China.
² Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
³ Department of Infection Control, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
⁴ Department of Information Centre, West China Hospital, Sichuan University, Chengdu, People's Republic of China.

^# Contributed equally.

Abstract

Background: There are few published reports describing the clinical characteristics of acute pancreatitis (AP) patients with multidrug-resistant organism (MDRO) infection.

Methods: This was a retrospective analysis of AP patients with MDRO infection in West China Hospital between July 2015 and June 2020. Basic clinical data, disease progression states, and prognoses of the MDRO and non-MDRO infection groups were compared and analyzed. Logistic regression analysis was performed to explore the related risk factors for MDRO infection. The prognoses of different MDRO infection types were compared.

Results: In total, 9812 AP patients were included, 2436 (24.83%) of whom had healthcare-associated infections (641 [26.31%] MDRO infections and 1795 [73.69%] non-MDRO infections). The main MDRO strain was carbapenem-resistant Acinetobacter baumannii (CRAB) (400/62.40%). The rate of discharge against doctor's advice, mortality, hospitalization expenses, and hospitalization days was higher in the MDRO infection group than in the noninfection group. By logistic regression analysis, the independent risk factors associated with MDRO infection included male sex (OR 1.36, 95% CI 1.09~1.70), severity (OR 1.40, 95% CI 1.10~1.78), ICU referral (OR 2.48, 95% CI 1.79~3.44), abdominal puncture (OR 2.78, 95% CI 1.93~4.02), fiberoptic bronchoscopy (OR 1.95, CI 1.35~2.81), and PICC/CVC placement (OR 1.48, CI 1.06~2.06). Compared with biliary and hypertriglyceridemia (HTG) (OR 0.94, 95% CI 0.73~1.23), alcohol (OR 0.30, 95% CI 0.19~0.47) and other etiologies (OR 0.58, 95% CI 0.41~0.81) conferred a lower risk of MDRO infection. The carbapenem-resistant Klebsiella pneumoniae (CRKP) infection rate was highest in the patients who died.

Conclusion: The CRAB proportion was highest in AP patients with MDRO infection. MDRO infection is related to many factors, has a poor prognosis, and increases the patient burden. CRKP infection is directly related to poor prognosis.

Keywords: acute pancreatitis; infection; multidrug-resistant organisms.

Grants and funding

The study was supported by the Science and Technological Supports Project of Sichuan Province, China (No. 2019YFS0389, GL and 2020YFS0268, DW).