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Bacteremia in the 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

doi: 10.1097/CCM.0b01e1828adba
Clinical Investigation: PDF Only

Objectives: To define the characteristic of bacteremia in the 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 this 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. And 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.

All authors: Jinling Hospital, Research Institute of General Surgery, Nanjing University School of Medicine, Nanjing, China.

Drs. Qiurong Li and Jieshou Li conceived and designed the study. Mr. Wang, Ms. Tang, Ms. He, and Dr. Ning Li performed the experiments. Dr. Qiurong Li and Mr. Wang analyzed the data and wrote and revised the manuscript. All authors approved the final version.

Supported, in part, by the National Basic Research Program (97 Program) in China (201CB5140 and 2009CB522405), National High-tech R&D Program (86 Program) of China (2012AA021007), National Natural Science Foundation in China (8107075), and Scientific Research Fund in Jiangsu Province (BK200917).

Dr. Qiurong Li is thankful for receiving the Deutscher Akademischer Austauschdienst Researcher Fellowship (Bioscience Special Program, Germany). The remaining authors have disclosed that they do not have any potential conflicts of interest.

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