Multidrug-resistant (MDR)
bacterial infection is a common complication of severe
acute pancreatitis (SAP).This study aimed to explore the
association between
human leukocyte antigen-
antigen D-related (
HLA-DR) expression and multidrug-resistant
infection in
patients with SAP.A total of 24 SAP
patients who were admitted to Nanjing Drum Tower
Hospital between May 2015 and December 2016 were enrolled in the study.The percentages of CD4+,CD8+,natural killer (NK),and
HLA-DR (CD14+)
cells and the CD4+/CD8+
cell ratio on days 1,7,14,and 28 after admission were determined by
flow cytometry.Eighteen
patients presented with the symptoms of
infection.Among them,55.6%
patients (10/18) developed MDR
infection.The most common causative MDR organisms were
Enterobacter cloacae and
Acinetobacter baumannii.The CD4+/CD8+
cell ratio and the percentage of
NK cells were
similar between
patients with non-MDR and
patients with MDR
infections.In
patients without
infection,the
HLA-DR percentage was maintained at a high level throughout the 28 days.Compared to the
patients without any
infection,the
HLA-DR percentage in
patients with non-MDR
infection was reduced on day 1 but increased and reached
similar levels on day 28.In
patients with MDR
infection,the
HLA-DR percentage remained below normal levels at all-
time points.It was concluded that persistent
down-regulation of
HLA-DR expression is associated with MDR
bacterial infection in
patients with SAP.