PhD Scientific Days 2026

Conservative Medicine

Microbiological Profile and Antimicrobial Resistance Patterns in Walled-Off Pancreatic Necrosis: A Single-Centre Retrospective Study

Name of the presenter

Brand, Tom

Institute/workplace of the presenter

Centre for Translational Medicine

Authors

Tom Brand¹, Peter Jeno Hegyi¹, Dominik Horvath¹
1: Centre for Translational Medicine

Text of the abstract

AIMS
The Revised Atlanta Classification identifies local complications of acute pancreatitis, including acute peripancreatic fluid collections, acute necrotic collections, pancreatic pseudocysts, and walled-off pancreatic necrosis (WOPN). WOPN often leads to secondary infections that worsen clinical outcomes. While endoscopic drainage is the preferred treatment, data on the microbiological characteristics of infected WOPN are limited. This study aims to identify microbial pathogens and their antibiotic resistance patterns in patients undergoing endoscopic stent placement for WOPN at a single tertiary care centre.
METHODS
This retrospective analysis included 51 patients with WOPN who underwent endoscopic ultrasound-guided placement of metal or plastic stents between January 1, 2022, and July 22, 2025. Microbiological cultures were collected from WOPN fluid during stent placement and from blood cultures. We recorded the isolated organisms and their resistance profiles and reviewed the corresponding antimicrobial therapies.
RESULTS
Among 51 patients, 37 had infected WOPN (72.5%) and 14 patients had sterile WOPN (27%) Polymicrobial infections were found in cyst cultures from 35/37 of infected cases (94.6%) while the remaining two patients had monomicrobial infection. The most frequently isolated organisms included Enterococcus spp. (56.75%), Klebsiella spp. (45.9%), and Pseudomonas spp. (43.2%). Fungal organisms, mainly Candida spp., were detected in 19 patients (51.3%). Organisms with Imipenem resistance were identified in 24 patients (64.8%), and empirical antibiotic therapy needed modification in 19 patients (51.3%).
CONCLUSIONS
This study highlights the high rate of bacterial and fungal infections in WOPN, underscoring the necessity for recognizing pathogen profiles to improve treatment protocols and strengthen antimicrobial stewardship in managing necrotizing pancreatitis.