Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection
Abstract Background Multidrug-resistant (MDR) Klebsiella pneumoniae infections, from pancreatic infections to bloodstream infections, influence the mortality of patients with acute pancreatitis (AP) on the condition of limited antibiotic choices. The aim of this study was to investigate the predicto...
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doaj-c3178a27cc444f53aaef02fe555b6a302021-09-26T11:55:29ZengBMCBMC Infectious Diseases1471-23342021-09-012111810.1186/s12879-021-06709-0Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infectionDi Wu0Junjie Ding1Yan Jia2Huanmiao Liu3Jie Xiao4Jie Peng5Department of Gastroenterology, Xiangya Hospital, Central South UniversityDepartment of Gastroenterology, Xiangya Hospital, Central South UniversityDepartment of Gastroenterology, Xiangya Hospital, Central South UniversityEmergency Department, Third Xiangya Hospital, Central South UniversityEmergency Department, Third Xiangya Hospital, Central South UniversityDepartment of Gastroenterology, Xiangya Hospital, Central South UniversityAbstract Background Multidrug-resistant (MDR) Klebsiella pneumoniae infections, from pancreatic infections to bloodstream infections, influence the mortality of patients with acute pancreatitis (AP) on the condition of limited antibiotic choices. The aim of this study was to investigate the predictor of mortality among AP patients complicated with MDR-K. pneumoniae infections. Methods Seventy-one AP patients who occurred MDR-K. pneumoniae infections from August 1st, 2016 to August 1st, 2020 were enrolled. MDR-K. pneumoniae was defined as the K. pneumoniae strain non-susceptible to at least one agent in three or more antimicrobial categories. MDR-K. pneumoniae isolates were confirmed by Vitek-2 system. Antibiotic susceptibility test was carried out using a micro broth dilution method. Clinical characteristics and drug-resistance rates were retrospectively reviewed, and the predictors of mortality were evaluated by univariate and multivariate analyses. Results The mortality rate of AP patients complicated with MDR-K. pneumoniae infections reached 46.5% (33 of 71), and pancreas (n = 53) was the most common site of MDR-K pneumoniae strains. The drug resistance rates of MDR-K. pneumoniae were high to 11 of 12 common antibiotics (more than 50.0%) except of tigecycline (23.9%). The predictor independently associated with mortality was septic shock (hazard ratio 2.959, 95% confidence intervals 1.396 – 6.272, P = 0.005). Conclusions More attention should be paid for pancreatic MDR-K. pneumoniae infections among AP patients The predictor for mortality of AP patients complicated with MDR-K. pneumoniae infection is septic shock. Therefore, further clinical investigations should focus on areas against septic shock.https://doi.org/10.1186/s12879-021-06709-0Acute pancreatitisMultidrug-resistant infectionMortalityDrug-resistancePredictor |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Di Wu Junjie Ding Yan Jia Huanmiao Liu Jie Xiao Jie Peng |
spellingShingle |
Di Wu Junjie Ding Yan Jia Huanmiao Liu Jie Xiao Jie Peng Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection BMC Infectious Diseases Acute pancreatitis Multidrug-resistant infection Mortality Drug-resistance Predictor |
author_facet |
Di Wu Junjie Ding Yan Jia Huanmiao Liu Jie Xiao Jie Peng |
author_sort |
Di Wu |
title |
Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection |
title_short |
Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection |
title_full |
Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection |
title_fullStr |
Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection |
title_full_unstemmed |
Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection |
title_sort |
predictors of mortality in acute pancreatitis complicated with multidrug-resistant klebsiella pneumoniae infection |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2021-09-01 |
description |
Abstract Background Multidrug-resistant (MDR) Klebsiella pneumoniae infections, from pancreatic infections to bloodstream infections, influence the mortality of patients with acute pancreatitis (AP) on the condition of limited antibiotic choices. The aim of this study was to investigate the predictor of mortality among AP patients complicated with MDR-K. pneumoniae infections. Methods Seventy-one AP patients who occurred MDR-K. pneumoniae infections from August 1st, 2016 to August 1st, 2020 were enrolled. MDR-K. pneumoniae was defined as the K. pneumoniae strain non-susceptible to at least one agent in three or more antimicrobial categories. MDR-K. pneumoniae isolates were confirmed by Vitek-2 system. Antibiotic susceptibility test was carried out using a micro broth dilution method. Clinical characteristics and drug-resistance rates were retrospectively reviewed, and the predictors of mortality were evaluated by univariate and multivariate analyses. Results The mortality rate of AP patients complicated with MDR-K. pneumoniae infections reached 46.5% (33 of 71), and pancreas (n = 53) was the most common site of MDR-K pneumoniae strains. The drug resistance rates of MDR-K. pneumoniae were high to 11 of 12 common antibiotics (more than 50.0%) except of tigecycline (23.9%). The predictor independently associated with mortality was septic shock (hazard ratio 2.959, 95% confidence intervals 1.396 – 6.272, P = 0.005). Conclusions More attention should be paid for pancreatic MDR-K. pneumoniae infections among AP patients The predictor for mortality of AP patients complicated with MDR-K. pneumoniae infection is septic shock. Therefore, further clinical investigations should focus on areas against septic shock. |
topic |
Acute pancreatitis Multidrug-resistant infection Mortality Drug-resistance Predictor |
url |
https://doi.org/10.1186/s12879-021-06709-0 |
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