Influencing factors and pathogenic characteristics of bloodstream infection in acute pancreatitis_West China Medical Journal

Authors：

 CHEN Jing , XIANG Qian , ZHENG Xiaojia

Department of Healthcare-associated Infection Control Center, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan 610072, P. R. China;

Corresponding?author：

CHEN Jing, Email: cjlwy0217@163.com

Keywords：

Acute pancreatitis; bloodstream infection; influencing factors; pathogenic bacteria

DOI：

10.7507/1002-0179.202601144

Video：

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Objective To explore the characteristics and influencing factors of bloodstream infection in patients with acute pancreatitis (AP), understand the characteristics of infectious pathogens, and provide references for formulating prevention and control measures for bloodstream infection in patients with AP. Methods The clinical data of patients with AP admitted to Sichuan Provincial People’s Hospital between January 2019 and February 2025 were retrospectively collected. Multivariate logistic regression analysis was employed to identify the influencing factors of bloodstream infection, and the characteristics of related pathogens was analyzed. Results A total of 1510 patients with AP were included, of whom 52 were complicated with bloodstream infections, with an infection rate of 3.44%. Multivariate logistic regression analysis revealed that gender [odds ratio (OR)=2.062, 95% confidence interval (CI) (1.045, 4.070)], hyperlipidemia [OR=0.207, 95%CI (0.077, 0.554)], and central venous catheterization [OR=4.093, 95%CI (1.765, 9.493)] were influencing factors for bloodstream infections (P<0.05). Among the pathogens identified in patients with AP complicated by bloodstream infections, Gram-negative bacteria accounted for the highest proportion (48.1%), with the main bacteria being Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii. Conclusions Gender, hyperlipidemia, and central venous catheterization are influencing factors for AP complicated with bloodstream infection. For with AP, it is necessary to strictly evaluate the indications for central venous catheterization and implement corresponding prevention and control measures to reduce the risk of infection.

Citation： CHEN Jing, XIANG Qian, ZHENG Xiaojia. Influencing factors and pathogenic characteristics of bloodstream infection in acute pancreatitis. West China Medical Journal, 2026, 41(3): 398-401. doi: 10.7507/1002-0179.202601144 Copy

1.	van den Berg FF, van Dalen D, Hyoju SK, et al. Western-type diet influences mortality from necrotising pancreatitis and demonstrates a central role for butyrate. Gut, 2021, 70(5): 915-927.
2.	Mederos MA, Reber HA, Girgis MD. Acute pancreatitis: a review. JAMA, 2021, 325(4): 382-390.
3.	Choi JH, Kim MH, Cho DH, et al. Revised Atlanta classification and determinant-based classification: which one better at stratifying outcomes of patients with acute pancreatitis?. Pancreatology, 2017, 17(2): 194-200.
4.	Brown LA, Hore TA, Phillips AR, et al. A systematic review of the extra-pancreatic infectious complications in acute pancreatitis. Pancreatology, 2014, 14(6): 436-443.
5.	Lu JD, Cao F, Ding YX, et al. Timing, distribution, and microbiology of infectious complications after necrotizing pancreatitis. World J Gastroenterol, 2019, 25(34): 5162-5173.
6.	Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. Lancet, 2020, 395(10219): 200-211.
7.	Timsit JF, Ruppé E, Barbier F, et al. Bloodstream infections in critically ill patients: an expert statement. Intensive Care Med, 2020, 46(2): 266-284.
8.	中華醫學會外科學分會胰腺外科學組. 中國急性胰腺炎診治指南(2021). 浙江實用醫學, 2021, 26(6): 511-519, 535.
9.	Selby LM, Rupp ME, Cawcutt KA. Prevention of central-line associated bloodstream infections: 2021 update. Infect Dis Clin North Am, 2021, 35(4): 841-856.
10.	Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Pennsylvania: Clinical and Laboratory Standards Institute, 2017.
11.	Hu JX, Zhao CF, Wang SL, et al. Acute pancreatitis: a review of diagnosis, severity prediction and prognosis assessment from imaging technology, scoring system and artificial intelligence. World J Gastroenterol, 2023, 29(37): 5268-5291.
12.	Jiang X, Shi JY, Wang XY, et al. The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study. Mil Med Res, 2020, 7(1): 38.
13.	Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet, 2015, 386(9988): 85-96.
14.	李麗, 杜金燁, 王心怡, 等. 肺炎克雷伯菌血流感染危險因素和菌株耐藥性及毒力分析. 檢驗醫學, 2025, 40(9): 885-891.
15.	黃麗萍, 林嘉萍, 余雪瑩, 等. 114 例成人肺炎克雷伯菌血流感染的臨床特征及預后. 中國感染與化療雜志, 2022, 22(6): 680-687.
16.	Kim JS, Holtom P, Vigen C. Reduction of catheter-related bloodstream infections through the use of a central venous line bundle: epidemiologic and economic consequences. Am J Infect Control, 2011, 39(8): 640-646.
17.	李娜, 唐志紅, 田永明. 2010-2018 年某醫院重癥監護病房老年病人耐碳青霉烯鮑曼不動桿菌血流感染危險因素及預后分析. 安徽醫藥, 2020, 24(5): 903-907.
18.	Mohus RM, Gustad LT, Furberg AS, et al. Explaining sex differences in risk of bloodstream infections using mediation analysis in the population-based HUNT study in Norway. Sci Rep, 2022, 12(1): 8436.
19.	Uslan DZ, Crane SJ, Steckelberg JM, et al. Age- and sex-associated trends in bloodstream infection: a population-based study in Olmsted County, Minnesota. Arch Intern Med, 2007, 167(8): 834-839.
20.	王燕, 齊文杰, 王超, 等. 重癥急性胰腺炎繼發感染的病原微生物分布和藥物敏感性研究. 臨床和實驗醫學雜志, 2023, 22(13): 1451-1455.
21.	李元振, 杜德仁, 郝海濱, 等. 重癥急性胰腺炎合并血流感染患者細菌分布和藥物敏感性研究. 醫學研究與戰創傷救治, 2024, 37(12): 1278-1282.
22.	Liu L, Yan H, Liu W, et al. Abdominal paracentesis drainage does not increase infection in severe acute pancreatitis: a prospective study. J Clin Gastroenterol, 2015, 49(9): 757-763.

1. van den Berg FF, van Dalen D, Hyoju SK, et al. Western-type diet influences mortality from necrotising pancreatitis and demonstrates a central role for butyrate. Gut, 2021, 70(5): 915-927.
2. Mederos MA, Reber HA, Girgis MD. Acute pancreatitis: a review. JAMA, 2021, 325(4): 382-390.
3. Choi JH, Kim MH, Cho DH, et al. Revised Atlanta classification and determinant-based classification: which one better at stratifying outcomes of patients with acute pancreatitis?. Pancreatology, 2017, 17(2): 194-200.
4. Brown LA, Hore TA, Phillips AR, et al. A systematic review of the extra-pancreatic infectious complications in acute pancreatitis. Pancreatology, 2014, 14(6): 436-443.
5. Lu JD, Cao F, Ding YX, et al. Timing, distribution, and microbiology of infectious complications after necrotizing pancreatitis. World J Gastroenterol, 2019, 25(34): 5162-5173.
6. Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. Lancet, 2020, 395(10219): 200-211.
7. Timsit JF, Ruppé E, Barbier F, et al. Bloodstream infections in critically ill patients: an expert statement. Intensive Care Med, 2020, 46(2): 266-284.
8. 中華醫學會外科學分會胰腺外科學組. 中國急性胰腺炎診治指南(2021). 浙江實用醫學, 2021, 26(6): 511-519, 535.
9. Selby LM, Rupp ME, Cawcutt KA. Prevention of central-line associated bloodstream infections: 2021 update. Infect Dis Clin North Am, 2021, 35(4): 841-856.
10. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Pennsylvania: Clinical and Laboratory Standards Institute, 2017.
11. Hu JX, Zhao CF, Wang SL, et al. Acute pancreatitis: a review of diagnosis, severity prediction and prognosis assessment from imaging technology, scoring system and artificial intelligence. World J Gastroenterol, 2023, 29(37): 5268-5291.
12. Jiang X, Shi JY, Wang XY, et al. The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study. Mil Med Res, 2020, 7(1): 38.
13. Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet, 2015, 386(9988): 85-96.
14. 李麗, 杜金燁, 王心怡, 等. 肺炎克雷伯菌血流感染危險因素和菌株耐藥性及毒力分析. 檢驗醫學, 2025, 40(9): 885-891.
15. 黃麗萍, 林嘉萍, 余雪瑩, 等. 114 例成人肺炎克雷伯菌血流感染的臨床特征及預后. 中國感染與化療雜志, 2022, 22(6): 680-687.
16. Kim JS, Holtom P, Vigen C. Reduction of catheter-related bloodstream infections through the use of a central venous line bundle: epidemiologic and economic consequences. Am J Infect Control, 2011, 39(8): 640-646.
17. 李娜, 唐志紅, 田永明. 2010-2018 年某醫院重癥監護病房老年病人耐碳青霉烯鮑曼不動桿菌血流感染危險因素及預后分析. 安徽醫藥, 2020, 24(5): 903-907.
18. Mohus RM, Gustad LT, Furberg AS, et al. Explaining sex differences in risk of bloodstream infections using mediation analysis in the population-based HUNT study in Norway. Sci Rep, 2022, 12(1): 8436.
19. Uslan DZ, Crane SJ, Steckelberg JM, et al. Age- and sex-associated trends in bloodstream infection: a population-based study in Olmsted County, Minnesota. Arch Intern Med, 2007, 167(8): 834-839.
20. 王燕, 齊文杰, 王超, 等. 重癥急性胰腺炎繼發感染的病原微生物分布和藥物敏感性研究. 臨床和實驗醫學雜志, 2023, 22(13): 1451-1455.
21. 李元振, 杜德仁, 郝海濱, 等. 重癥急性胰腺炎合并血流感染患者細菌分布和藥物敏感性研究. 醫學研究與戰創傷救治, 2024, 37(12): 1278-1282.
22. Liu L, Yan H, Liu W, et al. Abdominal paracentesis drainage does not increase infection in severe acute pancreatitis: a prospective study. J Clin Gastroenterol, 2015, 49(9): 757-763.

West China Medical Journal

Influencing factors and pathogenic characteristics of bloodstream infection in acute pancreatitis

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