Factors related to infection by multiple drug-resistant bacteria in infectious pancreatic necrosis / 中华肝胆外科杂志

ABSTRACT

Objective:To study the factors related to infection by multiple drug-resistant bacteria (MDROs) in patients with infectious pancreatic necrosis (IPN).Methods:A retrospective study was conducted on the clinical data of 134 IPN patients with definitive etiologies treated in the Department of General Surgery, the Third Affiliated Hospital of Guizhou Medical University from January 2009 to February 2020. There were 85 males and 49 females. The age was (46.69±14.11) years. The IPN patients were divided into the multiple and the non-multiple MDROs infection groups based on drug resistance of pathogens in drainage fluid. The difference between the two groups of patients, including the number of antibacterial drugs used, the number of combined antibacterial drugs, the length of ICU stay, and other related factors were analyzed. Univariate and multivariate analyses were performed.Results:Among the 134 patients with IPN, 41 (30.60%) had complex MDROs infection and 93 (69.40%) had non complex MDROs infection. Univariate analysis showed that the course of disease, APACHE II score, extrapancreatic infection, number of surgical operations, time from onset to operation, patency of drainage tube, length of ICU stay, time of using antibiotics, number of changing courses of antibiotics, number of combined antibiotics, blood glucose and glycosylated hemoglobin were related to occurrence of multiple MDROs (all P<0.05); Multivariate analysis showed that glycated hemoglobin ( OR=3.957, 95% CI 1.073-14.600), time from onset to operation ( OR=6.086, 95% CI 1.263-29.325), number of changing courses of antibiotics ( OR=3.560, 95% CI 1.077-11.772), number of combined antibiotics ( OR=3.560, 95% CI 1.077-11.772), length of ICU stay ( OR=3.590, 95% CI 1.126-11.448) were independent risk factors of MDROs infection in IPN patients ( P<0.05). Conclusion:Early debridement of infective foci, good control of blood glucose, reduced length of ICU stay, rational use of antibiotics to avoid unnecessary changing courses of antibiotics, appropriate use of combination of antibiotics could reduce the number of MDROs infection in IPN patients.