title: Emergence of antibiotic resistance in infected pancreatic necrosis.
abstract: BACKGROUND
  Overall, the use of antibiotics in the treatment of patients with severe acute pancreatitis has increased owing to the use of antibiotic prophylaxis.
  
  
  OBJECTIVE
  The incidence of antibiotic-resistant (AB-R) bacteria in infected pancreatitis is related to prolonged antibiotic treatment and may affect outcome.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Fifty-six-bed intensive care unit of a tertiary care center.
  
  
  METHODS
  Forty-six consecutive patients with infected pancreatic necrosis.
  
  
  METHODS
  Occurrence rate of AB-R organisms in pancreatic infection, overall duration of antibiotic treatment prior to infection, and mortality, defined as inhospital mortality.
  
  
  RESULTS
  Infection with AB-R microorganisms was found in 24 (52%) of 46 patients. Primary infection was present in 7 patients; in 21 patients, nosocomial surinfection with AB-R organisms occurred. Patients with AB-R infections were treated with antibiotics for a longer period (24 vs 15 days, P<.05), while disease severity and the incidence of organ failure were not statistically significantly different. The intensive care unit stay was significantly longer in patients with AB-R infections (23 vs 31 days, P = .02). Mortality was not statistically significantly different in patients with AB-R infections (37% vs 28%, P = .23).
  
  
  CONCLUSIONS
  The occurrence rate of infections with AB-R organisms in our patients with severe acute pancreatitis was high and was associated with a longer intensive care unit stay, but no increased mortality could be demonstrated. The duration of antibiotic treatment was increased in patients in whom AB-R infections developed.
authors.affiliation: Intensive Care Unit and Centre for Infectious Diseases, Ghent University Hospital, Ghent, Belgium. jan.dewaele@UGent.be
authors.forename: Jan J
authors.initials: JJ
authors.lastname: De Waele
authors.forename: Dirk
authors.initials: D
authors.lastname: Vogelaers
authors.forename: Eric
authors.initials: E
authors.lastname: Hoste
authors.forename: Stijn
authors.initials: S
authors.lastname: Blot
authors.forename: Francis
authors.initials: F
authors.lastname: Colardyn
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010195:Pancreatitis / Q000188:drug therapy / Q000382:microbiology*