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Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection

BACKGROUND: Multidrug-resistant (MDR) Klebsiella pneumoniae infections, from pancreatic infections to bloodstream infections, influence the mortality of patients with acute pancreatitis (AP) on the condition of limited antibiotic choices. The aim of this study was to investigate the predictor of mor...

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Autores principales: Wu, Di, Ding, Junjie, Jia, Yan, Liu, Huanmiao, Xiao, Jie, Peng, Jie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451102/
https://www.ncbi.nlm.nih.gov/pubmed/34544384
http://dx.doi.org/10.1186/s12879-021-06709-0
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author Wu, Di
Ding, Junjie
Jia, Yan
Liu, Huanmiao
Xiao, Jie
Peng, Jie
author_facet Wu, Di
Ding, Junjie
Jia, Yan
Liu, Huanmiao
Xiao, Jie
Peng, Jie
author_sort Wu, Di
collection PubMed
description BACKGROUND: Multidrug-resistant (MDR) Klebsiella pneumoniae infections, from pancreatic infections to bloodstream infections, influence the mortality of patients with acute pancreatitis (AP) on the condition of limited antibiotic choices. The aim of this study was to investigate the predictor of mortality among AP patients complicated with MDR-K. pneumoniae infections. METHODS: Seventy-one AP patients who occurred MDR-K. pneumoniae infections from August 1st, 2016 to August 1st, 2020 were enrolled. MDR-K. pneumoniae was defined as the K. pneumoniae strain non-susceptible to at least one agent in three or more antimicrobial categories. MDR-K. pneumoniae isolates were confirmed by Vitek-2 system. Antibiotic susceptibility test was carried out using a micro broth dilution method. Clinical characteristics and drug-resistance rates were retrospectively reviewed, and the predictors of mortality were evaluated by univariate and multivariate analyses. RESULTS: The mortality rate of AP patients complicated with MDR-K. pneumoniae infections reached 46.5% (33 of 71), and pancreas (n = 53) was the most common site of MDR-K pneumoniae strains. The drug resistance rates of MDR-K. pneumoniae were high to 11 of 12 common antibiotics (more than 50.0%) except of tigecycline (23.9%). The predictor independently associated with mortality was septic shock (hazard ratio 2.959, 95% confidence intervals 1.396 – 6.272, P = 0.005). CONCLUSIONS: More attention should be paid for pancreatic MDR-K. pneumoniae infections among AP patients The predictor for mortality of AP patients complicated with MDR-K. pneumoniae infection is septic shock. Therefore, further clinical investigations should focus on areas against septic shock.
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spelling pubmed-84511022021-09-20 Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection Wu, Di Ding, Junjie Jia, Yan Liu, Huanmiao Xiao, Jie Peng, Jie BMC Infect Dis Research BACKGROUND: Multidrug-resistant (MDR) Klebsiella pneumoniae infections, from pancreatic infections to bloodstream infections, influence the mortality of patients with acute pancreatitis (AP) on the condition of limited antibiotic choices. The aim of this study was to investigate the predictor of mortality among AP patients complicated with MDR-K. pneumoniae infections. METHODS: Seventy-one AP patients who occurred MDR-K. pneumoniae infections from August 1st, 2016 to August 1st, 2020 were enrolled. MDR-K. pneumoniae was defined as the K. pneumoniae strain non-susceptible to at least one agent in three or more antimicrobial categories. MDR-K. pneumoniae isolates were confirmed by Vitek-2 system. Antibiotic susceptibility test was carried out using a micro broth dilution method. Clinical characteristics and drug-resistance rates were retrospectively reviewed, and the predictors of mortality were evaluated by univariate and multivariate analyses. RESULTS: The mortality rate of AP patients complicated with MDR-K. pneumoniae infections reached 46.5% (33 of 71), and pancreas (n = 53) was the most common site of MDR-K pneumoniae strains. The drug resistance rates of MDR-K. pneumoniae were high to 11 of 12 common antibiotics (more than 50.0%) except of tigecycline (23.9%). The predictor independently associated with mortality was septic shock (hazard ratio 2.959, 95% confidence intervals 1.396 – 6.272, P = 0.005). CONCLUSIONS: More attention should be paid for pancreatic MDR-K. pneumoniae infections among AP patients The predictor for mortality of AP patients complicated with MDR-K. pneumoniae infection is septic shock. Therefore, further clinical investigations should focus on areas against septic shock. BioMed Central 2021-09-20 /pmc/articles/PMC8451102/ /pubmed/34544384 http://dx.doi.org/10.1186/s12879-021-06709-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Wu, Di
Ding, Junjie
Jia, Yan
Liu, Huanmiao
Xiao, Jie
Peng, Jie
Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection
title Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection
title_full Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection
title_fullStr Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection
title_full_unstemmed Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection
title_short Predictors of mortality in acute pancreatitis complicated with multidrug-resistant Klebsiella pneumoniae infection
title_sort predictors of mortality in acute pancreatitis complicated with multidrug-resistant klebsiella pneumoniae infection
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451102/
https://www.ncbi.nlm.nih.gov/pubmed/34544384
http://dx.doi.org/10.1186/s12879-021-06709-0
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