Prognostic Analysis Of Klebsiella Pneumonia In Patients With Severe Acute Pancreatitis

Objectives:To analyze the drug resistance of Klebsiella pneumoniae and to investigate the severe complications and prognosis of Klebsiella pneumoniae infection in patients with severe acute pancreatitis(SAP).Methods:Retrospective analysis of ICU of Sir Run Run Shaw Hospital affiliated to Medical College of Zhejiang University from January 2015 to June 2017 in 50 patients with pancreatic surgery group of Chinese Medical Association SAP diagnosis and classification standard and have infected specimens(blood fluid,peritoneal drainage)in patients with clinical data on the etiology,82 specimens of pathogenic microorganisms SAP secondary abdominal or bloodstream infection statistics and analysis drug resistance,Of which 21 cases of infection of Klebsiella pneumoniae(A group),29 cases of infection of other pathogens(B group),statistical laboratory indicators,the two groups of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ),sequential organ failure estimation(SOFA)score,mechanical ventilation time,mortality and other indicators,to analyze the prognosis of Klebsiella pneumoniae infection in severe acute pancreatitis.Results:Klebsiella pneumoniae to imipenem was 87.50%;A group and B group of SAP patients(age 55.43±17.76 vs 54.41 ± 13.28),male/female sex ratio(13/8 vs 18/11),APACHE Ⅱ score(20.24±7.78 vs 20.59±18.50),SOFA score(4.71 ±2.63 vs 5.38±4.97),organ function the damage of[ARDS(20 vs 26),AKI(7 vs 11),acute liver injury(11 vs 18)]and laboratory index,the difference was not statistically significant(p>0.05);A group and B group SAP patients required mechanical ventilation time(23.33±15.22 vs 14.41 ± 14.85),ICU hospitalization time(33.81 ± 20.94 vs 22.86±16.16)and complications(abdominal bleeding,intestinal fistula,hepatic abscess,chylous fistula)(11 vs 1),mortality(33.3%vs 10.3%),the B group is better than that of A group,the differences were statistically the significance(p<0.05).Conclusions:Klebsiella pneumoniae virulent strong,high resistance to carbapenem,SAP secondary pan-resistant Klebsiella pneumoniae abdominal infection or bloodstream infection,easily lead to abdominal bleeding,gastrointestinal fistula and other serious complications disease,so that ICU prolonged hospitalization,high mortality,poor prognosis.