Bloodstream infections after surgery for severe acute pancreatitis.

OBJECTIVE

To analyze the incidence and outcome of bloodstream infections (BSIs) in patients operated on for severe acute pancreatitis to identify the source and associated risk factors.

METHODS

We retrospectively (1995-2001) analyzed 45 patients treated surgically for severe acute pancreatitis. We recorded demographic characteristics, data on surgical and medical treatment and disease severity, the occurrence of BSIs, microbiological data concerning the BSIs and other infectious processes, the incidence of organ failure, and data on surgical and infectious complications.

RESULTS

Fifteen episodes of BSI were found in 7 of 45 patients (15%), with 18 organisms involved. In all but 1 episode, the source of the BSI was pancreatic necrosis. Most of the organisms were gram positive (11); the others were gram negative (6) or fungi (1). Mortality was statistically not different in patients with a BSI (57% vs. 35%). Multivariate analysis demonstrated that only the length of intensive care unit (ICU) stay was associated with the occurrence of BSIs (OR, 1.05; 95% CI, 1.02-1.09; P < 0.01).

CONCLUSION

A BSI is not a rare finding after surgery for severe acute pancreatitis, especially in patients with a prolonged ICU stay. The source is the infected necrosis in most of BSI episodes.