Table 1.
Baseline features of the study patients overall and in the antibiotic-exposed and unexposed groupsa
| Suspected IPN, n = 56 | Exposed, n = 33 | Unexposed, n = 23 | P value | |
|---|---|---|---|---|
| Age, y, median [IQR] | 58 [45.5;67.5] | 54.5 [45.5;64] | 63 [45;68.5] | 0.89 |
| Males, n (%) | 47 [84] | 26 [78] | 21 [91] | 0.28 |
| BMI, median [IQR] | 26.3 [23.6;29.5] | 25.7 [23, 29] | 26.9 [24.9;33] | 0.18 |
| Origin of pancreatitis | ||||
| Biliary | 16 (29) | 9 (27) | 7 (30.5) | 0.95 |
| Alcohol abuse | 23 (51) | 14 (43) | 9 (39) | |
| Otherb | 17 (30) | 10 (30) | 7 (30.5) | |
| SAPS IIc, median [IQR] | 38 (28;52) | 37 [24;52] | 39 [31;52] | 0.73 |
| CTSId, median [IQR] | 6 [4, 9] | 6 [4, 9] | 6 [4, 9] | 0.79 |
| No organ failuree, n (%) | 1 (2) | 0 | 1 (5) | 0.76 |
| 1 or 2 organ failures, n (%) | 41 (73) | 24 (73) | 17 (74) | |
| ≥3 organ failures, n (%) | 14 (25) | 9 (27) | 5 (21) | |
| Type of organ failure, n (%) | ||||
| Respiratory failure | 52 (93) | 31 (94) | 21 (92) | 0.99 |
| Mechanical ventilation | 43 (77) | 24 (73) | 19 (83) | 0.52 |
| Circulatory failure | 34 (61) | 20 (61) | 14 (61) | 0.99 |
| Renal failure | 33 (59) | 18 (55) | 15 (65) | 0.58 |
| Time from ICU admission to first procedure for IPN, days, median [IQR] | 21 [12, 29] | 25 [15, 36] | 19 [10–25] | 0.61 |
| IPN outcomes | ||||
| Total number of procedures for IPN, median [IQR] | 2 [1–3] | 2 [1.5–3] | 2 [1–2.75] | 0.99 |
| Confirmed IPN (positive sample culture), n (%) | 48 (85.7) | 30 (90) | 18 (78) | 0.25 |
| Number of positive samples/total number of samples (%) | 106 (77) | 74/91 (81) | 32/46 (70) | 0.58 |
| Patients developing a multidrug-resistant infectionf, n (%) | 15 (27) | 8 (24) | 6 (26) | 0.99 |
| Patients developing an extensively drug resistant infectiong, n (%) | 10 (17.8) | 6 (18) | 4 (17) | 0.99 |
| Patients with concomitant positive blood culture, n (%) | 18 (32) | 8 (24) | 10 (43) | 0.15 |
| Other outcomes | ||||
| Perforation of hollow organ, n (%) | 5 (9) | 4 (12) | 1 (4) | 0.63 |
| Bowel ischemia, n (%) | 3 (5) | 2 (6) | 1 (4) | 0.99 |
| Intestinal bleeding, n (%) | 11 (20) | 5 (15) | 6 (26) | 0.33 |
| ICU stay, days, median [IQR] | 24.5 [7–47] | 23 [8–48] | 28 [6–44] | 0.54 |
| Hospital stay, days, median [IQR] | 66.5 [42–96] | 68 [46.5–96] | 63 [42–101] | 0.68 |
| ICU mortality, n (%) | 9 (16) | 5 (15) | 4 (17) | 0.99 |
| Hospital mortality, n (%) | 9 (16) | 5 (15) | 4 (17) | 0.99 |
IPN infected pancreatic necrosis, IQR interquartile range, BMI body mass index, SAPS II Simplified Acute Physiology Score version II, CTSI Computed Tomography Severity Index, ICU intensive care unit
aExposure was defined as patients who were started on antibiotics more than 24 h before the first pancreatic sample was collected
bOther causes of pancreatitis: hypertriglyceridemia, drugs, endoscopic retrograde cholangiopancreatography, and unknown
cThe SAPS II can range from 0 (least severe) to 163 (most severe, with a 100% predicted risk of death); patients with a score of 50 have a 46.1% predicted risk of death
dThe CTSI can range from 0 to 10; the predicted risk of death is 6% for values in the 4–6 range and 17% for values in the 7–10 range
eOrgan failure was defined as a modified Marshall score (Supplemental Digital Content 1) ≥ 2 for the renal, respiratory, or cardiovascular system
fMultidrug-resistant bacteria were defined as bacteria with acquired non-susceptibility to at least one agent in three or more antimicrobial categories
gExtensively drug-resistant bacteria were defined as non-susceptibility to at least one agent in all but two or fewer antimicrobial categories