Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 22;23(1):340.
doi: 10.1186/s12879-023-08230-y.

The impact of multi-drug resistant Pseudomonas aeruginosa infections on acute pancreatitis patients

Di Wu #  1 , Wenjun Lu #  1 , Yilin Huang  1 , Ge Qin  1 , Huanmiao Liu  2 , Jie Xiao  2 , Jie Peng  3
Affiliations

The impact of multi-drug resistant Pseudomonas aeruginosa infections on acute pancreatitis patients

Di Wu et al. BMC Infect Dis. .

Abstract

Introduction: Acute pancreatitis (AP) accounts for a high proportion of digestive diseases worldwide and has a high risk of infection. Pseudomonas aeruginosa, a common pathogen of hospital infections, has been observed to increase the resistance rate to several antibiotics, causing difficulties in treatments. Our study aims to investigate the impact of the multi-drug resistant Pseudomonas aeruginosa (MDR-PA) infections on AP patients.

Methods: At two Chinese tertiary referral centers for AP patients infected with MDR-PA, a retrospective case-control study with a 1:2 case-control ratio was performed. Comparisons were preformed between with/without MDR-PA infections and different drug-resistance of MDR-PA infections patients, respectively. Independent risk factors of overall mortality were assessed via univariate and multivariate binary logistic regression analyses, and the distribution and antibiotic resistant rates of strains were described.

Results: Mortality in AP patients with MDR-PA infections was significantly higher than in those without MDR-PA infections (7 (30.4%) vs. 4 (8.7%), P = 0.048). The rate of prophylactic use of carbapenem for 3 days (0 vs. 50%, P = 0.019) and the incidence rate of multiple organ failure (MOF) (0 vs. 57.1%, P = 0.018) were remarkably higher in the carbapenem-resistant Pseudomonas aeruginosa group compared with the carbapenem-sensitive Pseudomonas aeruginosa group. In the multivariate analysis, the severe categories of AP (OR = 13.624, 95% CIs = 1.567-118.491, P = 0.018) and MDR-PA infections (OR = 4.788, 95% CIs = 1.107-20.709, P = 0.036) were independent risk factors for mortality. The resistance rates of MDR-PA strains were low for amikacin (7.4%), tobramycin (3.7%), and gentamicin (18.5%). The resistance rates of MDR-PA strains to imipenem and meropenem were up to, 51.9% and 55.6%, respectively.

Conclusion: In AP patients, severe categories of AP and MDR-PA infections were both independent risk factors for mortality. Inappropriate use of carbapenem antibiotics and MOF were related to carbapenem-resistant Pseudomonas aeruginosa infections. Amikacin, tobramycin, and gentamicin are recommended for the treatment of AP patients with MDR-PA infections.

Keywords: Acute pancreatitis; Drug resistance; Infection; Multi-drug resistant Pseudomonas aeruginosa; Risk factor.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Similar articles

See all similar articles

Cited by

References

    1. Petrov MS, Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat Rev Gastroenterol Hepatol. 2019;16(3):175–84. doi: 10.1038/s41575-018-0087-5. - DOI - PMC - PubMed
    1. Iannuzzi JP, King JA, Leong JH, Quan J, Windsor JW, Tanyingoh D, et al. Global incidence of Acute Pancreatitis is increasing over time: a systematic review and Meta-analysis. Gastroenterology. 2022;162(1):122–34. doi: 10.1053/j.gastro.2021.09.043. - DOI - PubMed
    1. Szatmary P, Grammatikopoulos T, Cai W, Huang W, Mukherjee R, Halloran C, et al. Acute Pancreatitis: diagnosis and treatment. Drugs. 2022;82(12):1251–76. doi: 10.1007/s40265-022-01766-4. - DOI - PMC - PubMed
    1. Shen Y, Cui NQ. Clinical observation of immunity in patients with secondary infection from severe acute pancreatitis. Inflamm Res. 2012;61(7):743–8. doi: 10.1007/s00011-012-0467-1. - DOI - PubMed
    1. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–11. doi: 10.1136/gutjnl-2012-302779. - DOI - PubMed

MeSH terms