Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project
Yükleniyor...
Dosyalar
Tarih
2019
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Springer
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
PurposeTo describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock).MethodsWe performed a multicenter (n=309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis.ResultsThe cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation.ConclusionThis multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection.
Açıklama
De Backer, Daniel/0000-0001-9841-5762; Pardo-Oviedo, Juan Mauricio/0000-0003-0084-3449; Szakmany, Tamas/0000-0003-3632-8844; Czuczwar, Miroslaw/0000-0002-9025-6717; Leone, Marc/0000-0002-3097-758X; Tiberio, Iolanda FLC/0000-0002-5662-7895; POTA, VINCENZO/0000-0001-9999-3388; Grigoras, Ioana/0000-0001-9412-9574; Zabolotskikh, Igor Borisovich/0000-0002-3623-2546; Pardo-Oviedo, Juan Mauricio/0000-0003-0084-3449; Gunst, Jan/0000-0003-2470-6393; Dimopoulos, George/0000-0002-3784-3103; Rello, Jordi/0000-0003-0676-6210; Corradi, Francesco/0000-0002-5588-2608; Uœnal, Necmettin/0000-0002-9440-7893; Tomescu, Dana/0000-0001-9673-5754; Gritsan, Alexey/0000-0002-0500-2887; Volta, Carlo/0000-0003-3533-6121; Morton, Ben/0000-0002-6164-2854; PANTAZOPOULOS, IOANNIS/0000-0002-8846-519X; Blot, Stijn/0000-0003-2145-0345; Trenado Alvarez, Jose/0000-0002-2930-0766; De Lange, Dylan/0000-0002-0191-7270; Smuszkiewicz, Piotr/0000-0003-3067-8229; Paul, Cherish/0000-0001-6133-0036; Paul, John/0000-0002-9307-3465; Labeau, Sonia/0000-0003-3863-612X; Velickovic, Dejan/0000-0002-7312-2880
WOS: 000493268200001
PubMed: 31664501
WOS: 000493268200001
PubMed: 31664501
Anahtar Kelimeler
Intra-abdominal infection, Peritonitis, Sepsis, Intensive care, Multidrug resistance, Mortality
Kaynak
Intensive Care Medicine
WoS Q Değeri
Q1
Scopus Q Değeri
Cilt
45
Sayı
12
