Frontiers in Cellular and Infection Microbiology (Mar 2023)

Escherichia coli infection indicates favorable outcomes in patients with infected pancreatic necrosis

  • Haosu Huang,
  • Haosu Huang,
  • Jie Peng,
  • Jie Peng,
  • Caihong Ning,
  • Caihong Ning,
  • Caihong Ning,
  • Qin Wei,
  • Qin Wei,
  • Qin Wei,
  • Jiarong Li,
  • Jiarong Li,
  • Jiarong Li,
  • Chiayen Lin,
  • Chiayen Lin,
  • Chiayen Lin,
  • Zefang Sun,
  • Zefang Sun,
  • Zefang Sun,
  • Lu Chen,
  • Lu Chen,
  • Lu Chen,
  • Shuai Zhu,
  • Shuai Zhu,
  • Shuai Zhu,
  • Dingcheng Shen,
  • Dingcheng Shen,
  • Dingcheng Shen,
  • Gengwen Huang,
  • Gengwen Huang,
  • Gengwen Huang

DOI
https://doi.org/10.3389/fcimb.2023.1107326
Journal volume & issue
Vol. 13

Abstract

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IntroductionInfected pancreatic necrosis (IPN) is a severe complication of acute necrotizing pancreatitis with increasing morbidity. Escherichia coli is the most frequently cultured microorganism in IPN. However, the implications of Escherichia coli infection on the outcomes of patients with IPN remain unclear. Therefore, this study aimed to evaluate the clinical impacts of Escherichia coli infection on IPN.MethodsA prospective database with consecutive patients with IPN between January 2010 and April 2022 at a tertiary hospital was post-hoc analyzed. The clinical and microbiological characteristics, surgical management, and follow-up data of patients with and without Escherichia coli infection were compared.ResultsA total of 294 IPN patients were enrolled in this cohort. Compared with non-Escherichia coli infection cases (n=80, 27.2%), patients with Escherichia coli infection (n=214, 72.8%) were characterized by more frequent polymicrobial infections (77.5% vs. 65.0%, P=0.04) but a lower occurrence of severe acute pancreatitis (SAP) (42.5% vs. 61.7%, P=0.003). In addition, significantly lower mortality (12.5% vs. 30.4%, p=0.002), fewer step-up surgical interventions (73.8% vs. 85.1%, P=0.025), and a lower rate of multiple organ failure (MOF) (25.0% vs. 40.2%, P=0.016) were also observed in patients with Escherichia coli infection. Multivariate analysis of mortality predictors indicated that MOF (odds ratio [OR], 6.197; 95% confidence interval [CI], 2.373–16.187; P<0.001) and hemorrhage (OR, 3.485; 95% CI, 1.623–7.487; P=0.001) were independent predictors associated with higher mortality in patients with IPN. Escherichia coli infection was significantly associated with a lower mortality (OR, 0.302; 95% CI, 0.121–0.751; P= 0.01).ConclusionEscherichia coli infection indicates a favorable prognosis in patients with IPN, although the mechanism needs further investigation.

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