摘要
目的探讨多重耐药菌(MDRO)感染性胰腺坏死(IPN)患者预后及其相关因素。方法回顾性分析2010年10月—2016年3月某院收治的53例有明确病原学依据IPN患者的临床资料,按引流液中病原菌耐药情况将IPN患者分为MDRO感染组和普通细菌感染组,比较两组患者的预后及其相关因素。结果 53例有明确病原学依据的IPN患者中,MDRO感染组33例(62.3%),普通细菌感染组20例(37.7%),IPN患者胰周引流液中最常见的MDRO是多重耐药的鲍曼不动杆菌(37.5%,18/48)。IPN患者的病死率为30.2%(16/53),MDRO感染组患者的病死率(39.4%,13/33)高于普通细菌感染组患者(15.0%,3/20)(P<0.05);与普通细菌感染组比较,MDRO感染组急性胰腺炎严重程度分级重、ICU住院时间长以及住院费用高(均P<0.05)。IPN患者病死率与MDRO感染、急性胰腺炎严重程度分级密切相关(均P<0.05)。结论 MDRO感染的IPN患者预后较差,治疗难度较大。MDRO感染已成为重症胰腺炎治疗的重要挑战之一。
Objective To investigate prognosis and related factors of infectious pancreatic necrosis（IPN） caused by multidrug-resistant organisms（MDROs）. Methods Clinical data of 53 IPN patients admitted to a hospital between October 2010 and March 2016 were analyzed retrospectively, patients were divided into MDRO infection group and common bacterial infection group according to antimicrobial resistance of pathogens isolated from peripancreatic drainge fluid, prognosis and related factors of two groups were compared. Results Among 53 IPN patients with confirmed evidence for pathogenicity, 33（62.3~）were in MDRO infection group, and 20（37. 7%）were in common bacterial infection group, the most common MDROs isolated from peripancreatic drainage was multidrug-resistant Acinetobacter baumannii （MDRO-AB）（37.5%, 18/48）. The mortality of IPN patients was 30.2M （16/53）, mor- tality of MDRO infection group was higher than common bacterial infection group（39. 4% [13/33] vs 15.0% [3/ 20], P〈0.05） ; the severity score, length of intensive care unit （ICU） stay, and hospitalization expenses in MDRO infection group were all higher than common bacterial infection group（all P〈0.05）. The mortality of IPN patients were closely associated with MDRO infection and severity score of acute pancreatitis （all P 〈0. 05 ）. Conclusion Prognosis of patients with MDRO infection is poor, treatment is difficult, MDRO infection has become one of the most important challenge to the treatment of severe acute pancreatitis.
出处
《中国感染控制杂志》
CAS
北大核心
2017年第3期203-206,共4页
Chinese Journal of Infection Control
基金
中南大学湘雅医院医院管理研究基金项目(2016GL12)
关键词
重症胰腺炎
感染性胰腺坏死
多重耐药菌
多重耐药菌感染
预后
severe pancreatitis
infectious pancreatic necrosis
multidrug resistance organism
multidrug resistanceorganism infection
prognosis
