多重耐药菌感染对急性坏死性胰腺炎患者的影响

Effect of Multidrug Resistant Bacterial Infection in patients with Acute Necrotizing pancreatitis

目的探讨多重耐药菌感染在急性胰腺炎病程中的影响。方法对华西医院2009年1月至2012年6月期间收治的134例胰腺坏死组织感染患者的临床资料进行回顾性分析。结果 134例患者中,为多重耐药菌感染者78例,非多重耐药菌感染者56例。外院转入共36例,其中多重耐药组转入者比例较非耐药组高(38.5%比10.7%,P=0.002)。多重耐药组患者的死亡率(20.5%比14.3%)及总住院时间(78 d比55 d)与非耐药组比较差异均无统计学意义(P>0.05);但多重耐药组患者ICU住院者比例较非耐药组高(48.7%比26.8%,P=0.01),且多重耐药组患者住ICU时间较非耐药组长(20 d比3 d,P<0.001)。结论多重耐药菌感染在坏死性胰腺炎患者尤其是转入患者当中的发生率较高,且其对患者ICU住院比例及住ICU时间的影响不能忽视。

Objective To investigate the effect of multidrug resistant （MDR） bacterial infection in clinical course of acute pancreatitis. Methods The medical records of 134 patients with a diagnosis of infected pancreatic necrosis in West China Hospital from Jan. 2003 to ]un. 2010 were reviewed. Results MDR microorganisms were found in 78 of the 134 patients. MDR group had higher rate of transferred patients than non-MDR group （38.5% vs. 10.7%, P=0.002）. The intensive care unit admission rate was significantly higher in patients with MDR bacterial infections （48.7% vs. 26.8%, P=0.01）. The mean intensive care unit stay was significantly longer in patients with MDR bacterial infections （20 days vs. 3 days, P〈0.001）. Mortality and total hospital stay was not significantly different in the patients with MDR infections vs. those without it （20.5% vs. 14.3%, P〉0.05; 78 d vs. 55 d, P〉0.05）. Conclusion Clinicians should be aware of the high incidence and impact of MDR infections in patients with acute necrotizing pancreatitis, especially in transferred patients.