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RESEARCH PRODUCT
Abdominal infections in the intensive care unit: characteristics, treatment and determinants of outcome
Marco MaggioriniIrene KarampelaJeffrey LipmanAnnika Reintam BlaserPeter AbelJoel StarkopfMałgorzata Mikaszewska-sokolewiczZoujair Salmen HalabiYannick MalledantSharon MicallefMassimo AntonelliMichael KuiperJordi RelloTobias BingoldAlvaro Rea-netoPablo MonederoManu MalbrainCintia GrionAndrew RhodesVera Maravic-stojkovicMarc-michael VentzkeGabriele WobkerFernando Martinez-sagastiDaniela FilipescuMarc LeoneClaudia SpiesRowan BurnsteinUwe TrieschmannAntonino GiarratanoTamas SzakmanyAlain LepapeMatthias GründlingPasquale De NegriThomas BerletMargaret HerridgeRandy WaxPiotr SmuszkiewiczJan De WaeleViktor SvigeljDorothy M BreenJulio César Mijangos-méndezOleg MalininMert AkanFrederico CarvalhoAndrea MorelliRafael ManezIoana GrigorasJean-louis Vincentsubject
Malehumanoslnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]Settore MED/41 - AnestesiologiaGUIDELINESlaw.inventionsepsislawAbdomenabdominal infections; crtitical carePrevalenceMedicine and Health SciencesMedicinePathologie maladies infectieusesAbdomen; Adult; Aged; Anti-Bacterial Agents; Bacterial Infections; Critical Illness; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Prevalence; Sepsis; Treatment Outcome; Young Adult; Intensive Care Units; Infectious Diseasesmediana edadMedicine(all)ancianoAbdominal Infection Sepsis Epic IIresultado del tratamientoprevalenciaBacterial InfectionsMiddle AgedadultoAbdominal infectionIntensive care unitAbscessAnti-Bacterial AgentsPREVALENCEadulto jovenIntensive Care UnitsTreatment OutcomeInfectious Diseasesmedicine.anatomical_structureSAPS IIAbdominal infection ; Abscess ; Peritonitis ; Severe sepsis ; Critical care ; Antibiotic therapy ; MicrobiologyFemaleSOFA score10023 Institute of Intensive Care MedicineantibacterianosResearch ArticleAdultmedicine.medical_specialtyCritical Illnessunidades de cuidados intensivosenfermedad críticaPeritonitis610 Medicine & healthNOSOCOMIAL INTRAABDOMINAL INFECTIONSPeritonitisMicrobiologySepsisYoung AdultMORBIDITYInternal medicineMANAGEMENTHumansAgedCANDIDASEPSISbusiness.industrySeptic shockMORTALITYAbdominal InfectionADULTS2725 Infectious DiseasesAntibiotic therapymedicine.diseaseSevere sepsisSurgeryCritical careCross-Sectional Studiesinfecciones bacterianasAbdomenbusinessestudios transversalesdescription
Background: Abdominal infections are frequent causes of sepsis and septic shock in the intensive care unit (ICU) and are associated with adverse outcomes. We analyzed the characteristics, treatments and outcome of ICU patients with abdominal infections using data extracted from a one-day point prevalence study, the Extended Prevalence of Infection in the ICU (EPIC) II.Methods: EPIC II included 13,796 adult patients from 1,265 ICUs in 75 countries. Infection was defined using the International Sepsis Forum criteria. Microbiological analyses were performed locally. Participating ICUs provided patient follow-up until hospital discharge or for 60 days.Results: Of the 7,087 infected patients, 1,392 (19.6%) had an abdominal infection on the study day (60% male, mean age 62 ± 16 years, SAPS II score 39 ± 16, SOFA score 7.6 ± 4.6). Microbiological cultures were positive in 931 (67%) patients, most commonly Gram-negative bacteria (48.0%). Antibiotics were administered to 1366 (98.1%) patients. Patients who had been in the ICU for ≤2 days prior to the study day had more Escherichia coli, methicillin-sensitive Staphylococcus aureus and anaerobic isolates, and fewer enterococci than patients who had been in the ICU longer. ICU and hospital mortality rates were 29.4% and 36.3%, respectively. ICU mortality was higher in patients with abdominal infections than in those with other infections (29.4% vs. 24.4%, p < 0.001). In multivariable analysis, hematological malignancy, mechanical ventilation, cirrhosis, need for renal replacement therapy and SAPS II score were independently associated with increased mortality.Conclusions: The characteristics, microbiology and antibiotic treatment of abdominal infections in critically ill patients are diverse. Mortality in patients with isolated abdominal infections was higher than in those who had other infections. © 2014 De Waele et al. licensee BioMed Central Ltd.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2014-07-29 |