Wu, Di 
ORCID: 0000-0002-5622-7488, Lu, Wenjun, Huang, Yilin, Qin, Ge, Liu, Huanmiao, Xiao, Jie and Peng, Jie
(2023)
The impact of multi-drug resistant <i>Pseudomonas aeruginosa</i> infections on acute pancreatitis patients.
BMC INFECTIOUS DISEASES, 23 (1).
340-.
Abstract
<h4>Introduction</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Acute pancreatitis, Drug resistance, Infection, Multi-drug resistant Pseudomonas aeruginosa, Risk factor |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 06 Feb 2024 11:12 |
| Last Modified: | 06 Feb 2024 11:12 |
| DOI: | 10.1186/s12879-023-08230-y |
| Open Access URL: | https://doi.org/10.1186/s12879-023-08230-y |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3178474 |
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