[Risk factors of infected pancreatic necrosis, its microbiology and antibiotic treatment].
Acute pancreatitis is associated with greater and smaller necrosis in 20% of the cases. The lethality rate of sterile and infected necrosis is 10 and 15-40%, respectively. The results of a retrospective and a prospective study in acute pancreatitis have been analyzed in this study. Twenty patients suffering from infected necrosis due to acute necrotising pancreatitis were selected into the retrospective study. They were divided into two groups: Group 1 (N = 10) survivors, Group 2 (N = 10) those who died. The fate of patients was determined by their age, the severity of pancreatitis, and the effectiveness of the operation. In a prospective study 63 patients were operated due to benign pancreatic disease with fluid collection. Microbiological samples were taken during surgery in every case. It could be stated that the Enterobacteriaceae spp. play the principal role in the infection, and the anaerobic bacteria occur sporadically. The omission of bacteriological sample taking during surgery frustrates the targeted antibiotic treatment. The blood culturing may have useful contribution. The targeted antibiotic therapy based on relevant microbiological sample taking is substantial complementary of the surgical intervention in the treatment of the inflammatory pancreatic diseases.
Pulay
I
I
Semmelweis Orvostudományi Egyetem, I. Sebészeti Klinika Budapest.
Konkoly
T M
TM
Arkosy
M
M
Tarjányi
M
M
Flautner
L
L
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000382:microbiology / Q000401:mortality / Q000473:pathology / Q000601:surgery; D004756:Enterobacteriaceae Infections / Q000382:microbiology / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010195:Pancreatitis / Q000382:microbiology* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
D000900:Anti-Bacterial Agents