Emergence of antibiotic resistance in infected pancreatic necrosis.
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.
De Waele
Jan J
JJ
Intensive Care Unit and Centre for Infectious Diseases, Ghent University Hospital, Ghent, Belgium. jan.dewaele@UGent.be
Vogelaers
Dirk
D
Hoste
Eric
E
Blot
Stijn
S
Colardyn
Francis
F
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*