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Objective: To investigate the changes of serum brain natriuretic peptide (BNP), procalcitonin (PCT) and recombinant single Ig IL1 related receptor (SIGIRR) in patients with emergency abdominal infection-related sepsis and their relationship with prognosis. Methods: 318 patients with emergency abdominal infection who were received by our hospital from January 2020 to October 2023 were divided into simple infection group (n=233) and sepsis group (n=85) according to whether sepsis occurred. The baseline data and serum BNP, PCT and SIGIRR levels were compared between groups. Pearson correlation analysis was used to explore the correlation between serum indicators and clinical data. The patients in sepsis group were classified into survival group (n=56) and death group (n=29) by means of survival status within 28 days, and the baseline data, serum BNP, PCT and SIGIRR were compared. Binary logistics equation was used to analyze the related influencing factors of prognosis of patients with sepsis. ROC curve was adopted to analyze the diagnostic value of serum BNP, PCT and SIGIRR levels on prognosis of sepsis group. Results: There were significant differences in pathogen types, WBC, CRP, ALB, APACHE II score and SOFA score between simple infection group and sepsis group (P<0.05). The levels of serum BNP, PCT and SIGIRR in simple infection group were significantly lower than those in sepsis group (P<0.05). Pearson correlation analysis showed that the levels of BNP, PCT and SIGIRR in sepsis group were positively correlated with WBC, CRP, APACHE II score and SOFA score (P<0.05), and were negatively correlated with ALB (P<0.05). Among patients with sepsis, the levels of serum BNP, PCT and SIGIRR were significantly higher in death group than those in survival group(P<0.05). Binary logistics regression analysis showed that serum BNP, PCT and SIGIRR levels were associated with poor prognosis in patients with sepsis(P<0.05). ROC curve revealed that the AUCs of serum BNP, PCT, SIGIRR alone and in combination in predicting the poor prognosis in patients with sepsis were 0.876, 0.826, 0.779 and 0.976, the sensitivities were 86.21%, 82.76%, 75.86% and 96.55%, and the specificities were 75%, 75%, 71.43% and 69.64% respectively, and the combined diagnostic value was higher. Conclusion: BNP, PCT and SIGIRR have a certain correlation with patients with abdominal infection-related sepsis, and can be used as reference indicators for clinical diagnosis, treatment and prognosis evaluation. [ABSTRACT FROM AUTHOR]

Objective: To investigate the quality of life of patients with severe acute pancreatitis (SAP), and to analyze the influencing factors of SAP complicated with abdominal infection. 136 patients with SAP in our hospital from January 2017 to December 2019 were selected and included in the study group. Another 90 volunteers who had physical examination in our hospital at the same time were selected as the control group. The patients in the study group were divided into infection group (n=48) and non infection group (n=88) according to the abdominal infection situation. Quality of life survey (SF-36) was used to evaluate the quality of life of the control group and the study group. The influencing factors of SAP complicated with abdominal infection were analyzed by univariate and multivariate logistic regression. The scores of social function, energy, physiological function, emotional function, physiological function, general health condition, physical pain and mental health of the study group were lower than those of the control group (P<0.05). Univariate analysis showed that mechanical ventilation time, multiple organ dysfunction syndrome, diabetes mellitus, hypoxemia, intestinal dysfunction time, renal failure, Acute physiology and chronic health status score II (APACHE Ⅱ) were associated with SAP complicated with abdominal infection (P<0.05), but not with gender, age, type of disease, etiology and respiratory failure (P>0.05). Multivariate Logistic regression analysis showed that multiple organ dysfunction syndrome, mechanical ventilation time≥ 10 h, intestinal dysfunction time≥ 4 d, renal failure, hypoxemia, APACHE Ⅱ>11 points were independent risk factors of SAP complicated with abdominal infection (P<0.05). Compared with healthy patients, patients with SAP have a lower quality of life and required continuous health intervention outside the hospital. In addition, SAP complicated with abdominal infection is associated with many factors, which should be paid attention to clinically and relevant countermeasures should be taken actively to improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

Objective: To analyze the common pathogenic bacteria and drug resistance of patients with abdominal infection after colorectal cancer surgery, and to explore the risk factors and the effect on the prognosis of patients. Methods: A retrospective study was conducted on 225 patients who underwent radical operation for colorectal cancer from January 2012 to January 2015. According to the occurrence of abdominal infection after operation, the patients were divided into infection group (31 cases) and uninfected group (194 cases). The suspected infected patients were identified by pathogen culture and drug sensitivity test, and the risk factors of abdominal infection after radical operation for colorectal cancer were analyzed. The mortality, progression-free survival (PFS) and recurrence rates were compared between the two groups. Results: The incidence of abdominal infection with patients after colorectal cancer surgery was 13.77%. A total of 67 strains of strains detected, gram negative bacteria had the highest detection rate, followed by gram-positive bacteria and fungi. Escherichia coli was sensitive to imipenem and the drug resistance rate was 0% . Klebsiella pneumoniae was sensitive to imipenem, Amikacin and tobramycin, and the drug resistance rates were 0%. Pseudomonas aeruginosa was sensitive to tobramycin, and the drug resistance rate was 11.11% . Staphylococcus epidermidis was more sensitive to levofloxacin, tobramycin, ciprofloxacin and imipenem, and the drug resistance rates were 0%, 0%, 12.50% and 12.50% respectively. Single factor analysis showed that abdominal infection after colorectal cancer surgery was related to preoperative hemoglobin level, preoperative serum albumin level, diabetes mellitus, TNM stage, Dukes stage, operation type, operation time, intraoperative bleeding, viscera resection, postoperative stoma, anastomotic fistula and postoperative drainage tube retention time (P<0.05). Multiple Logistic regression analysis showed that combined diabetes mellitus, combined visceral resection, preoperative serum albumin level<35 g/L, operation time>160 min, postoperative stoma, anastomotic fistula and postoperative drainage tube retention time≥ 11d were the independent risk factors of abdominal infection after colorectal cancer surgery (P<0.05). Compared with the uninfected group, the 3-year mortality and recurrence rate of the infected group was higher, and PFS was significantly shortened (P<0.05). Conclusion: Abdominal infection after colorectal cancer surgery is affected by many factors, with high infection rate and poor prognosis. The infection pathogenic bacteria are mainly gram-negative bacteria, and the antibiotics have certain resistance. Preventive measures should be taken for patients with diabetes mellitus, low preoperative serum albumin level,intraoperative combined visceral resection, long operation time, postoperative stoma, anastomotic fistula and long postoperative drainage tube retention time to prevent post-operative infection, and imipenem and tobramycin can be used to prevent and treat peritoneal infection caused by drug-resistant bacteria after radical resection of colorectal cancer. [ABSTRACT FROM AUTHOR]

Objective: To investigate the risk factors of abdominal infection after pancreaticoduodenectomy and analyze its etiological characteristics and drug sensitivity test. Methods: The clinical data of 60 cases undergoing pancreaticoduodenectomy in the 967th Hospital of the PLA Joint Logistics Support Force from January 2016 to December 2018 were retrospectively analyzed, the risk factors for postoperative abdominal infection were analyzed. The distribution and drug resistance of pathogenic bacteria in patients with postoperative abdominal infection were analyzed according to the results of bacterial culture and drug sensitivity test. Results: Univariate analysis showed that intraoperative blood transfusion, pulmonary infection, biliary fistula and pancreatic fistula were all related to the occurrence of abdominal infection (P<0.05). Multivariate Logistic regression analysis showed that intraoperative blood transfusion greater than 1000 mL, pulmonary infection, biliary fistula and pancreatic fistula were risk factors for abdominal infection after pancreaticoduodenectomy (P<0.05). A total of 54 strains were cultured in the peritoneal drainage fluid of 20 patients with postoperative abdominal infection. Among them, 23 strains (42.59%), 28 strains (51.85%) and 3 strains (5.56%) were Gram-positive bacteria. The main Gram-positive bacteria (Enterococcus faecalis, Staphylococcus epidermidis) were less sensitive to ciprofloxacin and erythromycin, all were below 17.00%, the sensitivity rates to linezolid and vancomycin were 100.00%. The main Gram-negative bacteria (Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae) less sensitive to ceftazidime, cefazolin and piperacillin, all were below or equal to 25.00%, the susceptibility rates to gentamicin and imipenem were higher, all were higher or equal to 80.00%. Conclusion: Excessive blood transfusion during operation and occurrence of pulmonary infection, biliary fistula and pancreatic fistula are risk factors for abdominal infection after pancreaticoduodenectomy. Antibiotics should be use targetedly in clinic according to the results of drug sensitivity test. [ABSTRACT FROM AUTHOR]