Abstract:

Objective To investigate clinical and bacteriological characteristics of early infections in patients with fulminant acute pancreatitis (FAP). Methods Eighty-two patients with FAP hospitalized in surgical intensive care unit were selected, and were classified into early infection group (with infection in 14 d from the disease onset, n=51) and non-infection group (without infection in 14 d from disease onset, n=31). The clinical data including infection related factors and 28 d mortality were compared between groups. And characteristics of infections and bacteriological characteristics of patients in early infection group were analyzed. Results The proportions of mechanical ventilation and surgical intervention in early infection group were significantly higher than those in non-infection group (P＜0.05). However, there was no significant difference in the other infection related factors and 28 d mortality between the two groups (P>0.05). In early infection group, 68 pathogens were isolated, which were 22 strains (32.4%) of gram positive bacteria, 29 strains (42.6%) of gram negative bacteria, and 17 strains (25.0%) of fungus. There were 11 cases (21.6%) of cholangitis, 24 cases (47.1%) of pneumonia, 8 cases (15.7%) of peri-pancreatic infection, 3 cases (5.9%) of bloodstream infection, 7 cases (13.7%) of wound infection, and 4 cases (7.8%) of urinary tract infection in early infection group. Conclusion The prevalence of early infection is high in patients with FAP, which may be related to mechanical ventilation and early surgical intervention. The main pathogen is gram negative bacteria, while gram positive bacteria and fungi also take an important part.

Key words: severe acute pancretitis, fulminant acute pancreatitis, infection, pathogen