title: Implications of culture positivity in acute pancreatitis: does the source matter?
abstract: OBJECTIVE
  Sepsis is an important complication and cause of morbidity and mortality in acute pancreatitis (AP). The source of sepsis may be infected pancreatic and peripancreatic collections and/or necrosis or extrapancreatic including infections in the bloodstream or respiratory and urinary tracts. We studied the implications of the source of sepsis on various outcome parameters in AP like persistent organ failure (POF), length of hospital (LOH) stay, and mortality.
  
  
  METHODS
  A retrospective analysis of culture reports of AP patients was done, and the outcome parameters were recorded.
  
  
  RESULTS
  Three hundred fifty-seven patients (229 M; age: 40.3 ± 14.04 years) of AP who had detailed culture reports were included. Eighty-four (23.5%) patients had pancreatic (or peripancreatic) source (group 1), 52 (14.6%) patients had other (extrapancreatic) sources (group 2), 20 (5.6%) patients were noted to have positive cultures from sources, which were both pancreatic and extrapancreatic (combined) sources (group 3), while 201 patients had sterile cultures. POF was seen in 147 (48%) patients (group 1: 67.8%; group 2: 65%; group 3: 90%; group 4: 34% [P < 0.001]). The mean LOH stay was 22.1 ± 20.26 days (group 1: 30.2 ± 20.64 days; group 2: 26.4 ± 26.82 days; group 3: 47.3 ± 32.60 days; group 4: 15.2 ± 11.34 days [P < 0.001]). Seventy (19.7%) patients succumbed to their illness (group 1 [22.9%]; group 2 [36.5%]; group 3 [40%]; group 4 [12%] [P < 0.001]).
  
  
  CONCLUSIONS
  POF and LOH stay were more common in patients with combined pancreatic and extrapancreatic sources of sepsis. Mortality was significantly higher in patients with sepsis (groups 1, 2, 3) compared with sterile groups.
authors: Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Chalapathi
authors: C
authors: Rao
authors: Deepak Kumar
authors: DK
authors: Bhasin
authors: Surinder Singh
authors: SS
authors: Rana
authors: Rajesh
authors: R
authors: Gupta
authors: Vikas
authors: V
authors: Gautam
authors: Kartar
authors: K
authors: Singh
mesh_terms: D000208:Acute Disease; D000328:Adult; D001419:Bacteria / Q000302:isolation & purification*; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D010195:Pancreatitis / Q000150:complications / Q000382:microbiology* / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology / Q000382:microbiology* / Q000401:mortality*