Risk Factors and Distribution of Pathogens for Pulmonary Infection in Patients with Severe Acute Pancreatitis
Source: By:shui quan Peng, peng Chen, di He
DOI: https://doi.org/10.30564/jams.v4i1.2848
Abstract:Objective: To investigate risk factors and distribution of pathogens for pulmonary infection in patients with severe acute pancreatitis. Methods: The clinical data of 285 patients with severe acute pancreatitis were retrospectively analyzed. Sputum specimens of patients with lung infections were studied. Univariate analysis and logistic regression were performed to screening the factors correlating to lung infections. Results: Gram-negative bacilli were the principal microorganisms isolated from those lung infections, and these bacterial pathogens demonstrated a marked pattern of antibiotic resistance. It was identified that age (OR 1.05, 95% CI 1.01-1.09, p=0.01), Ranson scores (OR 3.01 , 95% CI 1.13-8.03, p = 0.03) and surgical treatment (OR4.27, 95% CI 1.03-17.65, p = 0.04)were independent risk factors of lung infections in patients with severe acute pancreatitis. Conclusion: Analysis of pathogen spectrum and drug sensitivity will contribute to choosing antibiotics empirically. And preventive measures aimed at risk factors could help reduce the incidence of lung infections in patients with severe acute pancreatitis.
References:[1] Velusamy RK, Tamizhselvi R. Protective effect of methylsul-Fonylmethane in caerulein-induced acute pancreatitis and asso- Ciated lung in jury in mice[J]. JPharm Pharmacol,2018,70 (9):1188-1199. [2] Zhang WF,Li ZT,Fang JJ,et al.Effect of mannose on the Lung function of rats with acute pancreatitis[J].J Biol Regul Homeost Agents,2018,32(3):627-633. [3] Choi SB,Bae GS,Jo IJ,et al.Effects of Berberine on acute ne- Crotizing pancreatitis and associated lung injury[J].Pancreas, 2017,46(8):1046-1055. [4] Raghu M, Wig J, Kochhar R, et al. Lung complications in acute pancreatitis. JOP : Journal of the pancreas. 2007;8(2):177-85. [5] Restrepo R,Hagerott HE, Kulkarni S,et al.Acute pancreatitis in pediatric patients: demographics, etiology, anddiagnostic imaging[J].AJR Am J Roentgenol, 2016, 206(3): 632 -644. [6] Majidi S,Golembioski A,Wilson SL,et al.Acute pancreatitis:etiology, pathology, diagnosis, and treatment[J]. South Med J,2017,110(11):727-732. [7] Zhu R, Zhao Y, Li X,et al.Effects of penehyclidine hydro- chloride on severe acute pancreatitis-associated acute lung in-jury in rats[J].Biomed Pharmacother, 2018, 97: 1689-1693. [8] Qin Li, Cao Jingli, Ge Libin, et al.Comparison of the value of the modified Atlanta classification standard and the determinant-based classification standard for the prognosis of acute pancreatitis [J].Chinese Journal of Gastroenterology, 2019,39(1):52-55. [9] Wu Dong, Lu Bo, Xue Huadan, et al.A comparative study of the modified Atlanta classification and determinants based classification of acute pancreatitis [J].Chin J Med,2017,56 (12):909-913. [10] Liu.WJ, Zhang Y, Lu B. Clinical analysis of 45 cases of severe pancreatitis with pulmonary infection. Chinese Journal of Lung Diseases. 2017;10(06):723-725. [11] Hongzhang Cui, Shu Li, Caiming Xu, et al. Emodin alleviates severe acute pancreatitis-associated acute lung injuryby decreasing pre-B-cell colony-enhancing factor expression and promoting polymorphonuclearneutrophil apoptosis. 2017, 16(4):5121-5128. [12] Huang L, Wang M, Yang X, et al. Acute lung injury in patients with severe acute pancreatitis. The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology. 2013;24(6). [13] Wang X, Li Z, Yuan Y. Guidelines for the Diagnosis and Treatment of Acute Pancreatitis in China (Shanghai, 2013). Chinese Journal of Digestion. 2013(04):217-220. [14] Xu X, Wu A, Yi X. Clinical nosocomiology1998 2001-06-28. [15] Párniczky A, Kui B, Szentesi A, et al. Prospective, Multicentre, Nationwide Clinical Data from 600 Cases of Acute Pancreatitis. PloS one. 2016;11(10):e0165309. [16] Chen Zhongjian, Gou Fei, Zhang Tianfeng, et al.Effects of pulmonary infection on respiratory function and peripheral blood inflammatory cytokines in patients with severe acute pancreatitis [J].Chinese Journal of Nosocomiology, 2017,27(9): 2050-2053. [17] Li P, Shi Y. Interpretation of guidelines for diagnosis and treatment of nosocomial acquired pneumonia and ventilator-associated pneumonia. Chinese Journal of Evidence-Based Medicine. 2015;15(07):772-6. [18] Wang L, Wang X, Huang X, et al. Ventilator - associated pneumonia pathogen spectrum literature analysis. Chinese Journal of Nosocomiology. 2013;23(10):2478-80. [19] Gooszen H, Besselink M, van Santvoort H, et al. Surgical treatment of acute pancreatitis. Langenbeck's archives of surgery. 2013;398(6):799-806. [20] Wang Z, Xu W, Teng B. Perioperative stress response and postoperative inflammatory response in the treatment of severe pancreatitis by minimally invasive surgery and open surgery. Journal of Applied Medicine. 2016;32(12):1997-8.