Critical Care Medicine

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Critical Care Medicine:
doi: 10.1097/CCM.0b013e31828a3dba
Clinical Investigations

Bacteremia in Patients With Acute Pancreatitis as Revealed by 16S Ribosomal RNA Gene-Based Techniques*

Li, Qiurong MD, PhD; Wang, Chenyang MS; Tang, Chun BM; He, Qin MS; Li, Ning MD, PhD; Li, Jieshou MD, PhD

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Objectives: To define the characteristic of bacteremia in patients with acute pancreatitis and determine its possible association with the disease severity.

Design: A prospective controlled study.

Setting: ICU of Jinling Hospital, China.

Patients: A total of 48 patients with mild or severe acute pancreatitis were enrolled in the study.

Interventions: None.

Measurements and Main Results: Samples of peripheral blood were collected from the patients at 4 or 5 and 9 or 10 days after acute pancreatitis was definitely diagnosed. Resulting DNA from the blood was analyzed using denaturing gradient gel electrophoresis, and separated fragments were sequenced for identification of bacterial species. Bacterial DNA was detected in peripheral blood from 68.8% of patients with acute pancreatitis, and more than half (60.4%) of the patients encountered polymicrobial flora. Translocated bacteria in patients with acute pancreatitis were primarily constituted of opportunistic pathogens derived from the gut, including Escherichia coli, Shigella flexneri, Enterobacteriaceae bacterium, Acinetobacter lwoffii, Bacillus coagulans, and Enterococcus faecium. The species of circulating bacteria shifted remarkably among the patients with different severity. The presence of the bacteremia correlated positively with the Acute Physiology and Chronic Health Evaluation-II scores of patients with acute pancreatitis (r = 0.7918, p < 0.0001).

Conclusions: This study provides a detailed description on the prevalence of bacteremia and characteristic of bacterial species in patients with acute pancreatitis. We demonstrate an association between the bacteremia and the disease severity, which enables us to better understand a potential role of bacterial translocation in the pathogenesis of septic complication in acute pancreatitis.

© 2013 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins

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