Clinical characteristics,mortality risk factors,and antimicrobial resistance of Acinetobacter baumannii infection in acute pancreatitis patients
10.7659/j.issn.1005-6947.250203
- VernacularTitle:急性胰腺炎合并鲍曼不动杆菌感染患者的临床特征、死亡危险因素及耐药性分析
- Author:
Jixiang MO
1
;
Yan PENG
;
Jie PENG
Author Information
1. 湘潭医卫职业技术学院,湖南 湘潭 411104
- Publication Type:Journal Article
- Keywords:
Pancreatitis;
Acinetobacter baumannii;
Drug Resistance,Bacterial;
Death;
Risk Factors;
Nomograms
- From:
Chinese Journal of General Surgery
2025;34(7):1473-1480
- CountryChina
- Language:Chinese
-
Abstract:
Background and Aims:Acute pancreatitis(AP)is a common acute abdominal disease,with some patients progressing to moderately severe(MSAP)or severe acute pancreatitis(SAP).Secondary infection is a major determinant of prognosis.Carbapenem-resistant Acinetobacter baumannii(CRAB)has emerged as an important pathogen in AP,characterized by high drug resistance and mortality.This study aimed to comprehensively analyze the clinical characteristics,mortality risk factors,and antimicrobial resistance patterns of CRAB infection in MSAP/SAP patients,and to develop a predictive model.Methods:A retrospective cohort of 108 MSAP/SAP patients with CRAB infection admitted to Xiangya Hospital,Central South University,between January 2012 and August 2022 was analyzed.Clinical data,laboratory parameters,and antimicrobial susceptibility results were collected.Cox regression was performed to identify independent mortality risk factors,and a nomogram prediction model was constructed and validated.Results:The cohort comprised 108 patients(mean age 48 years,71.3%male).The leading etiologies were hypertriglyceridemia(61.1%)and biliary causes(33.3%).The most common infection sites were the pancreas/peripancreatic region(44.4%)and the lungs(43.5%).Overall mortality was 42.6%(46/108).Compared with survivors,deceased patients were older,more frequently had biliary etiology,ICU admission,mechanical ventilation,hemorrhage,and septic shock(all P<0.05).Multivariate Cox regression identified age>60 years(HR=6.694),hemorrhage(HR=4.466),septic shock(HR=4.495),and hemoglobin<80 g/L(HR=2.343)as independent predictors of death.Among 175 CRAB isolates,resistance rates exceeded 60%for most antibiotics,while tigecycline showed the lowest resistance(<40%).The nomogram model demonstrated excellent discrimination(C-index=0.897)and calibration,with an AUC of 0.897 for 90-day survival prediction.Conclusion:CRAB infection significantly worsens clinical outcomes in MSAP/SAP patients,with advanced age,hemorrhage,septic shock,and severe anemia as key mortality risk factors.The nomogram provides an effective tool for early identification of high-risk patients.Tailored therapeutic strategies,rational antibiotic use,and prevention of complications are essential to improving prognosis in this population.
