Adverse clinical outcomes associated with multidrug-resistant organisms in patients with infected pancreatic necrosis
Multidrug-resistant organisms (MDROs) is becoming a serious worldwide threat to public health. However, the impact of MDROs on the outcomes of the patients with infected pancreatic necrosis (IPN) remains unclear. This study aims to evaluate the roles of MDROs in IPN. A prospectively maintained datab...
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| Veröffentlicht in: | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2019-10, Vol.19 (7), p.935-940 |
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| container_title | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] |
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| creator | Ning, Caihong Huang, Gengwen Shen, Dingcheng Bonsu, Abdul Aziz F.K. Ji, Liandong Lin, Chiayen Cao, Xintong Li, Jiarong |
| description | Multidrug-resistant organisms (MDROs) is becoming a serious worldwide threat to public health. However, the impact of MDROs on the outcomes of the patients with infected pancreatic necrosis (IPN) remains unclear. This study aims to evaluate the roles of MDROs in IPN.
A prospectively maintained database of 188 patients with IPN between January 2010 and May 2019 was analyzed. The microbiology profile of organisms isolated from wall-off necrosis (WON) was specifically investigated to correlate with the outcomes of the patients.
Of the 188 patients with IPN, 108 patients (57.4%) had MDROs detected in aspirates from WON. Carbapenem-resistant Klebsiella pneumoniae (CRKP) accounted for 43.5% of the MDROs isolated (60/138), followed by Carbapenem-resistant Acinetobacter baumanii (CRAB) (34.8%, 48/138) and Escherichia coli producing an extended-spectrum beta-lactamase (ESBLp) (6.5%, 9/138). MDROs infection was associated with higher mortality (35.2% vs 11.3%, P |
| doi_str_mv | 10.1016/j.pan.2019.09.008 |
| format | Article |
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A prospectively maintained database of 188 patients with IPN between January 2010 and May 2019 was analyzed. The microbiology profile of organisms isolated from wall-off necrosis (WON) was specifically investigated to correlate with the outcomes of the patients.
Of the 188 patients with IPN, 108 patients (57.4%) had MDROs detected in aspirates from WON. Carbapenem-resistant Klebsiella pneumoniae (CRKP) accounted for 43.5% of the MDROs isolated (60/138), followed by Carbapenem-resistant Acinetobacter baumanii (CRAB) (34.8%, 48/138) and Escherichia coli producing an extended-spectrum beta-lactamase (ESBLp) (6.5%, 9/138). MDROs infection was associated with higher mortality (35.2% vs 11.3%, P < 0.001), higher rate of hemorrhage (36.1% vs 11.3%, P < 0.001), longer intensive care unit (ICU) stay (23 vs 12 days, P < 0.001), longer hospital stay (68 vs 51 days, P = 0.001) and more hospitalization expenses (45,190 ± 31,680 vs 26,965 ± 17,167 $, P < 0.001). Multivariate analysis of predictors of mortality indicated that MDROs infection (OR = 2.6; 95% confidence interval [CI], 1.0–6.5; P = 0.042), age ≥ 50 years (OR = 2.6; 95% CI, 1.2–5.8; P = 0.016), severe category (OR = 2.9; 95% CI, 1.1–8.0; P = 0.035), bloodstream infection (OR = 3.4; 95% CI, 1.5–7.6; P = 0.049), step-down surgical approach (OR = 2.7; 95% CI, 1.1–6.2; P = 0.023) were significant factors.
MDROs infection was prevalent among patients with IPN and associated with adverse clinical outcomes and increased mortality.</description><identifier>ISSN: 1424-3903</identifier><identifier>EISSN: 1424-3911</identifier><identifier>DOI: 10.1016/j.pan.2019.09.008</identifier><identifier>PMID: 31558390</identifier><language>eng</language><publisher>Switzerland: Elsevier B.V</publisher><subject>Acute pancreatitis ; Adult ; Aged ; Anti-Bacterial Agents - pharmacology ; Antibiotics ; Bacteria - drug effects ; Bacterial Infections - microbiology ; Clinical outcomes ; Drug Resistance, Multiple, Bacterial ; E coli ; Endoscopy ; Female ; Fungal infections ; Hemorrhage ; Hospitals ; Humans ; Infected pancreatic necrosis ; Male ; Microorganisms ; Middle Aged ; Mortality ; Multidrug resistance ; Multidrug resistant organisms ; Multivariate analysis ; Necrosis ; Odds Ratio ; Pancreas ; Pancreatitis ; Pancreatitis, Acute Necrotizing - microbiology ; Pancreatitis, Acute Necrotizing - mortality ; Patients ; Public health ; Retrospective Studies ; Sepsis ; Staphylococcus infections ; β Lactamase</subject><ispartof>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2019-10, Vol.19 (7), p.935-940</ispartof><rights>2019 IAP and EPC</rights><rights>Copyright © 2019 IAP and EPC. Published by Elsevier B.V. All rights reserved.</rights><rights>2019. IAP and EPC</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-c3d5f6827dc6801649903844ef95e1c047a69c3ff407adcbbd1074b381309d503</citedby><cites>FETCH-LOGICAL-c424t-c3d5f6827dc6801649903844ef95e1c047a69c3ff407adcbbd1074b381309d503</cites><orcidid>0000-0002-7651-9293 ; 0000-0003-1426-8000</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31558390$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ning, Caihong</creatorcontrib><creatorcontrib>Huang, Gengwen</creatorcontrib><creatorcontrib>Shen, Dingcheng</creatorcontrib><creatorcontrib>Bonsu, Abdul Aziz F.K.</creatorcontrib><creatorcontrib>Ji, Liandong</creatorcontrib><creatorcontrib>Lin, Chiayen</creatorcontrib><creatorcontrib>Cao, Xintong</creatorcontrib><creatorcontrib>Li, Jiarong</creatorcontrib><title>Adverse clinical outcomes associated with multidrug-resistant organisms in patients with infected pancreatic necrosis</title><title>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</title><addtitle>Pancreatology</addtitle><description>Multidrug-resistant organisms (MDROs) is becoming a serious worldwide threat to public health. However, the impact of MDROs on the outcomes of the patients with infected pancreatic necrosis (IPN) remains unclear. This study aims to evaluate the roles of MDROs in IPN.
A prospectively maintained database of 188 patients with IPN between January 2010 and May 2019 was analyzed. The microbiology profile of organisms isolated from wall-off necrosis (WON) was specifically investigated to correlate with the outcomes of the patients.
Of the 188 patients with IPN, 108 patients (57.4%) had MDROs detected in aspirates from WON. Carbapenem-resistant Klebsiella pneumoniae (CRKP) accounted for 43.5% of the MDROs isolated (60/138), followed by Carbapenem-resistant Acinetobacter baumanii (CRAB) (34.8%, 48/138) and Escherichia coli producing an extended-spectrum beta-lactamase (ESBLp) (6.5%, 9/138). MDROs infection was associated with higher mortality (35.2% vs 11.3%, P < 0.001), higher rate of hemorrhage (36.1% vs 11.3%, P < 0.001), longer intensive care unit (ICU) stay (23 vs 12 days, P < 0.001), longer hospital stay (68 vs 51 days, P = 0.001) and more hospitalization expenses (45,190 ± 31,680 vs 26,965 ± 17,167 $, P < 0.001). Multivariate analysis of predictors of mortality indicated that MDROs infection (OR = 2.6; 95% confidence interval [CI], 1.0–6.5; P = 0.042), age ≥ 50 years (OR = 2.6; 95% CI, 1.2–5.8; P = 0.016), severe category (OR = 2.9; 95% CI, 1.1–8.0; P = 0.035), bloodstream infection (OR = 3.4; 95% CI, 1.5–7.6; P = 0.049), step-down surgical approach (OR = 2.7; 95% CI, 1.1–6.2; P = 0.023) were significant factors.
MDROs infection was prevalent among patients with IPN and associated with adverse clinical outcomes and increased mortality.</description><subject>Acute pancreatitis</subject><subject>Adult</subject><subject>Aged</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Antibiotics</subject><subject>Bacteria - drug effects</subject><subject>Bacterial Infections - microbiology</subject><subject>Clinical outcomes</subject><subject>Drug Resistance, Multiple, Bacterial</subject><subject>E coli</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Fungal infections</subject><subject>Hemorrhage</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infected pancreatic necrosis</subject><subject>Male</subject><subject>Microorganisms</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multidrug resistance</subject><subject>Multidrug resistant organisms</subject><subject>Multivariate analysis</subject><subject>Necrosis</subject><subject>Odds Ratio</subject><subject>Pancreas</subject><subject>Pancreatitis</subject><subject>Pancreatitis, Acute Necrotizing - microbiology</subject><subject>Pancreatitis, Acute Necrotizing - mortality</subject><subject>Patients</subject><subject>Public health</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Staphylococcus infections</subject><subject>β Lactamase</subject><issn>1424-3903</issn><issn>1424-3911</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9r3DAQxUVpaf60HyCXIuglF28lS7YlegohTQKBXtqz0ErjRIstbTVyQr59ZTbNoYfAgATze8N7M4SccbbhjPffdpu9jZuWcb1htZh6R465bGUjNOfvX_9MHJETxB1jbcu5_kiOBO86VRvHZLnwj5ARqJtCDM5ONC3FpRmQWsTkgi3g6VMoD3RephJ8Xu6bDBiw2Fhoyvc2BpyRhkj3tgSIBQ94iCO4VVw9ugy152gEl1PVfiIfRjshfH55T8nvH1e_Lm-au5_Xt5cXd42rzkvjhO_GXrWDd72qgaWuWZSUMOoOuGNysL12YhwlG6x3263nbJBbobhg2ndMnJLzw9x9Tn8WwGLmgA6myUZIC5q21ZqLoRtkRb_-h-7SkmN1Z1rBme6VVivFD9SaAzOMZp_DbPOz4cysNzE7U_Oa9SaG1WKqar68TF62M_hXxb8jVOD7AYC6iscA2aCri3TgQ64rND6FN8b_BVZRnh8</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Ning, Caihong</creator><creator>Huang, Gengwen</creator><creator>Shen, Dingcheng</creator><creator>Bonsu, Abdul Aziz F.K.</creator><creator>Ji, Liandong</creator><creator>Lin, Chiayen</creator><creator>Cao, Xintong</creator><creator>Li, Jiarong</creator><general>Elsevier B.V</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7651-9293</orcidid><orcidid>https://orcid.org/0000-0003-1426-8000</orcidid></search><sort><creationdate>201910</creationdate><title>Adverse clinical outcomes associated with multidrug-resistant organisms in patients with infected pancreatic necrosis</title><author>Ning, Caihong ; Huang, Gengwen ; Shen, Dingcheng ; Bonsu, Abdul Aziz F.K. ; Ji, Liandong ; Lin, Chiayen ; Cao, Xintong ; Li, Jiarong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-c3d5f6827dc6801649903844ef95e1c047a69c3ff407adcbbd1074b381309d503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acute pancreatitis</topic><topic>Adult</topic><topic>Aged</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Antibiotics</topic><topic>Bacteria - drug effects</topic><topic>Bacterial Infections - microbiology</topic><topic>Clinical outcomes</topic><topic>Drug Resistance, Multiple, Bacterial</topic><topic>E coli</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Fungal infections</topic><topic>Hemorrhage</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infected pancreatic necrosis</topic><topic>Male</topic><topic>Microorganisms</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multidrug resistance</topic><topic>Multidrug resistant organisms</topic><topic>Multivariate analysis</topic><topic>Necrosis</topic><topic>Odds Ratio</topic><topic>Pancreas</topic><topic>Pancreatitis</topic><topic>Pancreatitis, Acute Necrotizing - microbiology</topic><topic>Pancreatitis, Acute Necrotizing - mortality</topic><topic>Patients</topic><topic>Public health</topic><topic>Retrospective Studies</topic><topic>Sepsis</topic><topic>Staphylococcus infections</topic><topic>β Lactamase</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ning, Caihong</creatorcontrib><creatorcontrib>Huang, Gengwen</creatorcontrib><creatorcontrib>Shen, Dingcheng</creatorcontrib><creatorcontrib>Bonsu, Abdul Aziz F.K.</creatorcontrib><creatorcontrib>Ji, Liandong</creatorcontrib><creatorcontrib>Lin, Chiayen</creatorcontrib><creatorcontrib>Cao, Xintong</creatorcontrib><creatorcontrib>Li, Jiarong</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ning, Caihong</au><au>Huang, Gengwen</au><au>Shen, Dingcheng</au><au>Bonsu, Abdul Aziz F.K.</au><au>Ji, Liandong</au><au>Lin, Chiayen</au><au>Cao, Xintong</au><au>Li, Jiarong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adverse clinical outcomes associated with multidrug-resistant organisms in patients with infected pancreatic necrosis</atitle><jtitle>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</jtitle><addtitle>Pancreatology</addtitle><date>2019-10</date><risdate>2019</risdate><volume>19</volume><issue>7</issue><spage>935</spage><epage>940</epage><pages>935-940</pages><issn>1424-3903</issn><eissn>1424-3911</eissn><abstract>Multidrug-resistant organisms (MDROs) is becoming a serious worldwide threat to public health. However, the impact of MDROs on the outcomes of the patients with infected pancreatic necrosis (IPN) remains unclear. This study aims to evaluate the roles of MDROs in IPN.
A prospectively maintained database of 188 patients with IPN between January 2010 and May 2019 was analyzed. The microbiology profile of organisms isolated from wall-off necrosis (WON) was specifically investigated to correlate with the outcomes of the patients.
Of the 188 patients with IPN, 108 patients (57.4%) had MDROs detected in aspirates from WON. Carbapenem-resistant Klebsiella pneumoniae (CRKP) accounted for 43.5% of the MDROs isolated (60/138), followed by Carbapenem-resistant Acinetobacter baumanii (CRAB) (34.8%, 48/138) and Escherichia coli producing an extended-spectrum beta-lactamase (ESBLp) (6.5%, 9/138). MDROs infection was associated with higher mortality (35.2% vs 11.3%, P < 0.001), higher rate of hemorrhage (36.1% vs 11.3%, P < 0.001), longer intensive care unit (ICU) stay (23 vs 12 days, P < 0.001), longer hospital stay (68 vs 51 days, P = 0.001) and more hospitalization expenses (45,190 ± 31,680 vs 26,965 ± 17,167 $, P < 0.001). Multivariate analysis of predictors of mortality indicated that MDROs infection (OR = 2.6; 95% confidence interval [CI], 1.0–6.5; P = 0.042), age ≥ 50 years (OR = 2.6; 95% CI, 1.2–5.8; P = 0.016), severe category (OR = 2.9; 95% CI, 1.1–8.0; P = 0.035), bloodstream infection (OR = 3.4; 95% CI, 1.5–7.6; P = 0.049), step-down surgical approach (OR = 2.7; 95% CI, 1.1–6.2; P = 0.023) were significant factors.
MDROs infection was prevalent among patients with IPN and associated with adverse clinical outcomes and increased mortality.</abstract><cop>Switzerland</cop><pub>Elsevier B.V</pub><pmid>31558390</pmid><doi>10.1016/j.pan.2019.09.008</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-7651-9293</orcidid><orcidid>https://orcid.org/0000-0003-1426-8000</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2019-10, Vol.19 (7), p.935-940 |
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| subjects | Acute pancreatitis Adult Aged Anti-Bacterial Agents - pharmacology Antibiotics Bacteria - drug effects Bacterial Infections - microbiology Clinical outcomes Drug Resistance, Multiple, Bacterial E coli Endoscopy Female Fungal infections Hemorrhage Hospitals Humans Infected pancreatic necrosis Male Microorganisms Middle Aged Mortality Multidrug resistance Multidrug resistant organisms Multivariate analysis Necrosis Odds Ratio Pancreas Pancreatitis Pancreatitis, Acute Necrotizing - microbiology Pancreatitis, Acute Necrotizing - mortality Patients Public health Retrospective Studies Sepsis Staphylococcus infections β Lactamase |
| title | Adverse clinical outcomes associated with multidrug-resistant organisms in patients with infected pancreatic necrosis |
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