Impact of carbapenem-resistant Acinetobacter baumannii infections on acute pancreatitis patients

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) infections present great challenges in clinical practices with high mortality. The aim of this study is to identify the impact of CRAB infections on acute pancreatitis (AP). Methods: A case-control study was performed via collecting data from March 1st, 2016 to August 1st, 2020 in two comprehensive teaching hospital. Clinical data of the CRAB-positive AP patients were analyzed and compared to a matched control group (case-control ratio of 1:1). Comparisons were preformed between with/without CRAB infections and multiple organ failure (MOF), respectively. Independent risk factors of overall mortality were determined via univariate and multivariate analyses. Results: CRAB infections were associated with higher mortality (49.2% vs. 23.0%, P < 0.01). CRAB combined with MOF increased a mortality up to 90% (P < 0.01). MOF (Odds ratio (OR) = 21.49, 95% confidence interval (CI) = 5.26-87.80, P < 0.01), CRAB infections (OR = 3.58, 95%CI = 1.24-10.37, P = 0.02) and hemorrhage (OR = 3.70, 95%CI = 1.21-11.28, P = 0.02) were independent risk factors of overall mortality. Lung was the most common site of strains (37 of 82). CRAB strains were highly resistant (>60%) to ten of eleven common antibiotics, except for tigecycline (28%). Conclusion: High mortality rate in AP patients was associated with CRAB infections and further increased when CRAB infections combined with MOF. (c) 2021 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Automated summary

This study demonstrates that CRAB infections are associated with high mortality rate in patients with acute pancreatitis, and the mortality rate further increases when CRAB infections are combined with multiple organ failure (MOF). The lungs are the most common site of CRAB strains, and these strains exhibit high resistance to most antibiotics.