Guo Xiaolan, Xu Yao, Li Kaiwei, Zhang Jingzhu, Tong Zhihui, Li Weiqin, Hong Donghuang
Department of Critical Care Medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, 134 Dongjie Street, Fuzhou, Gulou District, China.
Center of Severe Acute Pancreatitis, Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
BMC Infect Dis. 2025 Jul 1;25(1):882. doi: 10.1186/s12879-025-11263-0.
Infectious pancreatic necrosis (IPN) is associated with the prognosis of acute pancreatitis (AP). The correlation between microbial diversity in the peripancreatic region and AP severity remains unclear. This study investigates whether pathogen profiles in peripancreatic necrosis differ between IPN patients with and without organ failure (OF), using 16 S ribosomal RNA (16 S rRNA) and internal transcribed spacer (ITS) sequencing.
Patients with acute pancreatitis meeting clinical diagnostic criteria for IPN were prospectively enrolled. These patients were subsequently divided into an OF group and a non-OF group. Peripancreatic necrotic fluid samples were collected via percutaneous drainage and subjected to 16 S rRNA and ITS sequencing.
A total of 28 patients with suspected infected pancreatic necrosis (IPN) were included, with 14 patients in the OF group and 14 in the non-OF group. No significant difference was observed in bacterial alpha diversity between the OF and non-OF groups. However, beta diversity showed significant differences according to Welch's t test (P < 0.001), Adonis analysis (P = 0.037) and Anosim analysis (P = 0.032). The relative abundance of Klebsiella significantly differed between the two groups (2.79% vs. 34.14%, P = 0.0093) and correlated with the length of hospital stay (r = 0.422, P = 0.025).
The peripancreatic microbial profile is associated with the severity of acute pancreatitis, with Klebsiella being the dominant microflora in patients with IPN combined with OF.
感染性胰腺坏死（IPN）与急性胰腺炎（AP）的预后相关。胰腺周围区域微生物多样性与AP严重程度之间的相关性仍不清楚。本研究使用16S核糖体RNA（16S rRNA）和内转录间隔区（ITS）测序，调查有或没有器官衰竭（OF）的IPN患者胰腺周围坏死中的病原体谱是否存在差异。
前瞻性纳入符合IPN临床诊断标准的急性胰腺炎患者。这些患者随后被分为OF组和非OF组。通过经皮引流收集胰腺周围坏死液样本，并进行16S rRNA和ITS测序。
共纳入28例疑似感染性胰腺坏死（IPN）患者，OF组14例，非OF组14例。OF组和非OF组之间的细菌α多样性未观察到显著差异。然而，根据韦尔奇t检验（P < 0.001）、Adonis分析（P = 0.037）和Anosim分析（P = 0.032），β多样性显示出显著差异。两组之间克雷伯菌的相对丰度显著不同（2.79%对34.14%，P = 0.0093），且与住院时间相关（r = 0.422，P = 0.025）。
胰腺周围微生物谱与急性胰腺炎的严重程度相关，克雷伯菌是合并OF的IPN患者中的主要微生物群。
