| [ Summary ] |
Secondary infection of pancreatic and peripancreatic necrotic tissue is a serious complication with acute pancreatitis, resulting in significant morbidity and mortality. Infection typically presents 2 weeks after the onset of pancreatitis, is heralded by a worsening clinical course, often with sepsis or progression of multi organ failure. Enteric organisms, including Gram-negative rods and anaerobic bacteria, most commonly cause pancreatic infections. In severe acute pancreatitis, the prevalence of enteric organisms in necrotic pancreatic tissue has been linked to bacterial translocation from the gut due to increased intestinal mucosal permeability. Prophylactic treatment with antibiotics may reduce the number of pancreatic infections relation to acute pancreatitis, but this has been associated with the emergence of super-infections by MRSA and Candida specie. Furthermore, gut decontamination and totalenteral nutrition may also reduce pancreatic infection. |