Fungal infection but not type of bacterial infection is associated with a high mortality in primary and secondary infected pancreatic necrosis.
Dig Surg
; 21(4): 297-304, 2004.
Article
in En
| MEDLINE
| ID: mdl-15365228
ABSTRACT
INTRODUCTION:
Knowledge of microbiology in the prognosis of patients with necrotizing pancreatitis is incomplete.AIM:
This study compared outcomes based on primary and secondary infection after surgery for pancreatic necrosis.METHOD:
From a limited prospective database of pancreatic necrosectomy, a retrospective case note review was performed (October 1996 to April 2003).RESULTS:
55 of 73 patients had infected pancreatic necrosis at the first necrosectomy. 25 of 47 patients had resistant bacteria to prophylactic antibiotics (n = 21) or did not receive prophylactic antibiotics (n = 4), but this was not associated with a higher mortality (9 of 25) compared to those with sensitive organisms (4 of 22). Patients with fungal infection (n = 6) had a higher initial median (95% CI) APACHE II score compared to those without (11 (9-13) verus 8.5 (7-10), p = 0.027). Five of six patients with fungal infection died compared to 13 of 47 who did not (p = 0.014). With the inclusion of secondary infections 21 (32%) of 66 patients had fungal infection with 10 (48%) deaths compared to 11 (24%) of 45 patients without fungal infection (p = 0.047).CONCLUSION:
Whether associated with primary or secondary infected pancreatic necrosis, fungal but not bacterial infection was associated with a high mortality.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pancreatitis, Acute Necrotizing
/
Mycoses
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
Language:
En
Journal:
Dig Surg
Journal subject:
GASTROENTEROLOGIA
Year:
2004
Document type:
Article
Affiliation country:
United kingdom
Publication country:
CH
/
SUIZA
/
SUÍÇA
/
SWITZERLAND