Infectious complications account for approximately
80% of deaths in severe acute necrotizing
pancreatitis. The objective of our study was to determine
the role of invasive procedures for the development of
infected pancreas necrosis with bacteria resistant to firstline
antibiotics. Patients and Methods: For the present
investigation, a prospective, nonrandomized study design
was used. The study population consisted of 47 consecutive
patients with severe necrotizing pancreatitis.
Data related to infectious complications was collected,
and statistical analysis was performed to reveal factors
influencing the occurrence of infected necrosis induced
by bacteria resistant to first-line antibiotics. Results: Our
study showed a biphasic mode of the disease, with infectious
complications manifesting on the 3rd-4th week
after onset of pancreatitis. Statistical analysis revealed
that early fine needle aspiration (FNA) of pancreatic
necrosis (days 8-14 of disease) and prolonged duration
of central venous (CV) catheterization were independent
risk factors for development of infected necrosis induced
by bacteria resistant to first-line antibiotics, but the latter
had an even stronger relationship to the occurrence of
generalized septicemia. Conclusion: FNA of pancreatic
necrosis during the first 2 weeks after onset of acute pancreatitis
is a risk factor for development of infected
necrosis induced by bacteria resistant to first-line antibiotics.
Ultrasound-guided aspirations should only be performed
in patients with signs of sepsis.