Frontiers in Cellular and Infection Microbiology (Nov 2022)

Impact of multiple drug-resistant Gram-negative bacterial bacteraemia on infected pancreatic necrosis patients

  • Di Wu,
  • Di Wu,
  • Yan Jia,
  • Wenhao Cai,
  • Wenhao Cai,
  • Yilin Huang,
  • Arjun Kattakayam,
  • Diane Latawiec,
  • Robert Sutton,
  • Jie Peng

DOI
https://doi.org/10.3389/fcimb.2022.1044188
Journal volume & issue
Vol. 12

Abstract

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IntroductionMultiple drug-resistant Gram-negative bacterial (MDR-GNB) bacteraemia poses a serious threat to patients in hospital. Infected pancreatic necrosis (IPN) patients are a vulnerable population to infectious complications during hospitalization. This study aims to evaluate the impact of MDR Gram-negative bacteraemia on IPN patients.MethodsA case–control study was performed with data collected from 1 January 2016 to 1 July 2022 in a Chinese tertiary teaching hospital. Clinical data of the IPN patients with MDR-GNB bacteraemia were analyzed and compared to those of a matched control group without MDR-GNB bacteraemia (case–control ratio of 1:2). Comparisons were performed between with/without MDR-GNB bacteraemia and different severities of acute pancreatitis (AP). Independent predictors of overall mortality were identified via univariate and multivariate binary logistic regression analyses.ResultsMDR-GNB bacteraemia was related to a higher mortality rate (62.5% vs. 8.3%, p < 0.001). Severe AP combined with MDR-GNB bacteraemia further increased mortality up to 81.3% (p = 0.025). MDR-GNB bacteraemia (odds ratio (OR) = 8.976, 95% confidence interval (CI) = 1.805 –44.620, p = 0.007) and severe AP (OR = 9.414, 95% CI = 1.742 –50.873, p = 0.009) were independent predictors of overall mortality. MDR- Klebsiella pneumoniae was the most common causative pathogen.ConclusionA higher mortality rate in IPN patients was related to MDR-GNB bacteraemia and further increased in severe AP patients combined with MDR-GNB bacteraemia.

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