合并感染并发症坏死性胰腺炎病人的致病菌微生物学特点及应对策略

目的 探讨坏死性胰腺炎(necrotizing pancreatitis,NP)感染并发症的发生时间、分布和微生物学特点.方法 回顾性收集2014年1月至2020年12月就诊于首都医科大学宣武医院的295例NP病人的临床资料,分析存在感染性并发症的NP病人感染时间、感染部位及感染菌种的不同.结果 (1)该研究中,合并感...

Microbiological characteristics and counter-measures of pathogenic bacteria in patients with necrotizing pancreatitis with infectious complications

Objective To explore the characteristics of infection time,infection site and infectious strain in necrotizing pancreatitis(NP)patients with infectious complications.Methods From January 2014 to December 2020,clinical data of NP patients were collected retrospectively.Statistical analysis of infectious bacteria,infection site and infection time was performed.Results A total of 867 strains of pathogenic bacteria were isolated from 215 patients with NP infection,including 350 strains from pancreatic infections and 517 strains from extra-pancreatic infections.Gram-negative bacteria of Escherichia coli and Pseudomonas aeruginosa were the predominant infectious species.Extra-pancreatic infection time was earlier than pancreatic infection time[(9.8±9.0)vs.(14.6±13.5)days].As for early extra-pancreatic infection(≤14 days),bacteremia and respiratory tract infection were predominant.For late extra pancreatic infection(>14 days),bacteremia,catheter associated infection and urinary tract infection were predominant.Drug sensitivity analysis revealed that P.aeruginosa was sensitive to enzymatic penicillin,third/fourth-generation cephalosporins and carbapenems;A.baumannii and K.pneumoniae sensitive only to tigecycline;S.epidermidis and E.faecium highly sensitive to linezolid,tigecycline and vancomycin.Conclusion Gram-negative bacteria of K.pneumoniae and P.aeruginosa are the major pathogens in NP patients with infectious complications.And multiple drug-resistant bacteria are predominant.And time of extra-pancreatic infection is earlier than pancreatic infection time.Third/fourth-generation cephalosporins or carbapenem antibiotics may be used empirically.