文章摘要

ESKAPE 血流感染对急性坏死型胰腺炎预后的影响

作者: 1杨双汇, 1杨慧明, 1黄耿文, 1李宜雄
1 中南大学湘雅医院 胰腺胆道外科，湖南 长沙 410008
通讯: 黄耿文 Email: gengwenhuang@outlook.com
DOI: 10.3978/.10.3978/j.issn.1005-6947.2015.03.017

摘要

目的：探讨ESKAPE 血流感染对急性坏死性胰腺炎（ANP）患者预后及并发症的影响。 方法：回顾性分析2003 年1 月—2014 年7 月收治的有血培养结果的87 例ANP 患者，其中血培养阴 性49 例，阳性38 例，分析血流感染，尤其是ESKAPE 血流感染对ANP 患者治疗结果的影响。 结果：在38 例血培养阳性ANP 患者的69 份的病原学结果中，40.6% 为ESKAPE，其中鲍曼不动杆 菌占比50.0%， 其余依次为屎肠球菌（14.3%）、肺炎克雷伯菌（10.7%）， 肠杆菌属（10.7%）， 金黄色葡萄球菌（7.1%）和铜绿假单胞菌（7.1%）。血流感染患者休克、呼吸衰竭、肾功能衰竭 与消化道出血等并发症的发生率、病死率、住院费用及ICU 住院天数均较非血流感染患者明显增高 （均P<0.05）；ESKAPE 血流感染患者休克发生率以及住院费用均高于非ESKAPE 血流感染患者（均 P<0.05）。 结论：血流感染明显增加ANP 患者的并发症和病死率。ESKAPE 是导致ANP 患者血流感染的主要病 原体，其与患者休克的发生密切相关。
关键词： 胰腺炎，急性坏死性 感染 鲍氏不动杆菌

Impact of ESKAPE bloodstream infection on prognosis of acute necrotizing pancreatitis

Authors: 1YANG Shuanghui, 1YANG Huiming, 1HUANG Gengwen, 1LI Yixiong
1 Division of Pancreatic-Biliary Surgery, Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, China

CorrespondingAuthor:HUANG Gengwen Email: gengwenhuang@outlook.com

Abstract

Objective: To investigate the impact of ESKAPE bloodstream infection on the prognosis and complications in patients with acute necrotizing pancreatitis (ANP). Methods: Eighty-seven ANP patients admitted from January 2003 to July 2014 with blood culture results were retrospectively studied. Of the patients, 49 cases had negative and 38 cases had positive blood culture. The impact of bloodstream infection, especially ESKAPE bloodstream infection on therapeutic outcomes of these ANP patients was analyzed. Results: In the 69 pathogen test results from the 38 ANP patients with positive blood culture, 40.6% were ESKAPE pathogens that included Acinetobacter baumanni (50.0%), Enterococcus faecium (14.3%), Klebsiella pneumonia (10.7%), Enterobacter species (10.7%), Staphylococcus aureus (7.1%) and Pseudomonas aeruginosa (7.1%). Patients with bloodstream infection had significantly increased incidence of shock, respiratory failure, renal failure and digestive tract bleeding and mortality, as well as increased hospital expenses and prolonged length of ICU stay compared with those without bloodstream infection (all P<0.05). Patients with ESKAPE bloodstream infection had higher incidence of shock and hospital expenses than those with non-ESKAPE bloodstream infection (both P<0.05). Conclusion: Bloodstream infection can significantly increase the complications and mortality in ANP patients. ESKAPE are the major pathogens resulting in bloodstream infection in ANP patients, and are also closely associated with occurrence of shock in the patients.
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