Pathogenic Spectrum And Drug Resistance Of Secondary Infection In Severe Acute Pancreatitis

Objective: To study the pathogen spectrum,pathogen distribution and drug resistance of secondary infection of severe acute pancreatitis,and provide references for the selection of infection prevention and treatment strategies such as disease assessment,treatment methods and antibiotic use.Research methods: The clinical data of 55 patients with secondary infection of severe acute pancreatitis who were hospitalized in the Department of Pancreatic Biliary Surgery of the First Affiliated Hospital of China Medical University from January 2016 to January 2018 were collected.All patients were confirmed by bacterial or fungal culture.In addition to the general baseline characteristics,we also analyzed the location of infection and the type,distribution characteristics of the pathogens,and the drug resistance rate of common infectious pathogens.Results: A total of 181 pathogenic bacteria were collected from pancreas/pancreatic,blood,respiratory,urinary,and biliary systems in 55 patients,including 98Gram-negative bacteria,57 Gram-positive bacteria,and 26 fungi.The most common infections occur in the blood system(66 strains),followed by pancreatic/peripancreatic infection(58 strains).Acinetobacter baumannii,Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae and Stenotrophomonas maltophilia are the main species among the Gram-negative bacteria;Gram-positive bacteria are mainly caused by Enterococcus faecium and Staphylococcus;fungi are mainly composed of Candida albicans,Candida parapsilosis,Candida genus,and Candida sphaeroides.The resistance rates of common Gram-negative bacteria to cephalosporins,quinolones and carbapenems are much higher than those of monitoring value;The resistance rate of Acinetobacter baumannii to tigecycline was 29%,and the drug resistance situation was very serious.Common Gram-positive infections have a high resistance rate to erythromycin,tetracycline and penicillin.There were no drug resistance to linezolid,tigecycline,vancomycin and quinupristin/dalofopine.The detection rates of MRSA and MRCNS in Staphylococcus was high,,No resistant strains were found in the fungus.Conclusion: The pathogens of secondary infection of SAP are mainly Gram-negativebacteria.The most common pathogens of infection are Acinetobacter baumannii,Enterococcus faecium,Pseudomonas aeruginosa,Klebsiella pneumoniae and Escherichia coli.Blood system is the most common infected site,followed by pancreatic/peripancreatic infection.Hospital-acquired infections play an important role in SAP secondary infections,the drug resistance situation is very serious and needs to be paid enough attention.