What is the analysis and treatment of postoperative abdominal infection of the pancreas

  Objective To investigate the distribution characteristics, drug sensitivity and corresponding therapeutic measures of pathogenic bacteria of post-pancreatic surgery abdominal cavity infection.  Methods We retrospectively analyzed 113 cases of pancreatic surgery in our hospital from January 2012 to December 2012, collected patients’ intra-abdominal surgical site drainage fluid for bacterial culture and drug sensitivity test, and analyzed the results of bacterial culture of abdominal drainage fluid and the characteristics of abdominal infection after pancreatic surgery.  The results showed that 45 cases of 113 patients had abdominal infection after surgery, with an incidence of 39.8%. The culture of intra-abdominal drainage fluid obtained 54 strains of bacteria, mainly Gram-negative bacteria, accounting for 90.7%; Gram-positive bacteria were 7.4% and fungi were 1.9%. The most common strains were Pseudomonas aeruginosa 50.0% (27/54), Acinetobacter baumannii 14.8% (8/54) and A. oddis 11.1% (6/54). Gram-negative bacteria had high susceptibility to polymyxin B and aminoglycosides (>70%) and high resistance to imipenem and cephalosporins. There was a correlation between pancreatic fistula and abdominal infection.  Conclusion The pathogenic bacteria of post-pancreatic intra-abdominal infection in our hospital are mainly Gram-negative bacteria, especially the high infection rate and high drug resistance of Pseudomonas aeruginosa, suggesting a serious situation of bacterial resistance in post-pancreatic intra-abdominal infection. The choice of empirical medication should avoid the use of broad-spectrum antibiotics alone and select antibiotics according to the drug sensitivity results as much as possible; early pancreatic fistula may have a suggestive effect on abdominal cavity infection and should be given sufficient attention.