6533b870fe1ef96bd12d06af
RESEARCH PRODUCT
Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units
Dirk VogelaersStijn BlotAndries Van Den BergePhilippe MontraversGuy FrancoisSonia LabeauKoen BlotMieke DeschepperMassimo AntonelliJeffrey LipmanAmin LamrousCecilia PereyraFernando LipovestkyDespoina KoulentiJan De WaeleJoao Rezende-netoYenny CardenasTomas VymazalHans Fjeldsoee-nielsenPhilippe MontraversMatthias KottArvaniti KostoulaYash JaveriMassimo GirardisSharon EinavDylan De LangeLuis Daniel Umezawa MakikadoAdam MikstackiJosé-artur PaivaDana TomescuAlexey GritsanBojan JovanovicKumaresh VenkatesanTomislav MirkovicEmilio MasedaYalim DikmenBenedict Creagh-brownAmin LamrousMonica EmmerichMariana CanaleLorena Silvina DietzSantiago IlutovichJohn Thomas Sanchez MiñopeRamona Baldomera SilvaMartin Alexis MontenegroPatricio MartinPablo SaulViviana ChediackGiselle SuttonRocio CouceCarina BalasiniSusana GonzalezFlorencia Maria LascarEmiliano Jorge DescotteNatalia Soledad GumielaCarina Alejandra PinoCristian CesioEmanuel ValgolioEleonora CuntoCecilia DominguezFernando LipovestkyNydia Funes NelsonEsteban Martin AbegaoCecilia PereyraNorberto Christian PozoLuciana BianchiEnrique CorregerMaria Laura PastorinoErica Aurora MiyazakiNorberto Christian PozoNicolas GrubissichMariel GarciaNatalia BonettoNoelia Elizabeth QuevedoCristina Delia GomezFelipe QuetiLuis Gonzalez EstevarenaRuben FernandezIgnacio SantolayaNorberto Christian PozoSergio Hugo GrangeatJuan DogliaGraciela ZakalikCarlos PellegriniMaria Monserrat LloriaMercedes Esteban ChaconMariela FumaleMariela LeguizamonIrene Beatriz HidalgoRoberto Julian TirantiPaola CapponiAgustin TitaLuis CardonnetLisandro BettiniAgñel RamosLuciano LovesioEdith Miriam MirandaAngelica Beatriz FarfanCarina TolosaLise SeguraAdelina BellocchioBrian AlvarezAdriana ManzurRodolfo LujanNatalia FernandezNahuel ScaroneAlan ZazuCarina GrohJason FletcherJulie SmithRaman AzadNitin ChavanHelen WongMark KolLewis CampbellDespoina KoulentiTherese StarrBrigit RobertsBradley WibrowTimothy WarhurstMeher ChinthamuneediBernal Buitrago FerneyMarc SimonDaniel De BackerXavier WitteboleDavid De BelsVincent CollinKarolien DamsPhilippe JorensJasperina DuboisJan GunstLionel HaentjensNicolas De SchryverThierry DugernierJoao Rezende-netoSandro RizoliPaul SantillanYi HanEwelina BiskupChangjing QuXinyu LiTao YuLu WeihuaDaniel Molano-francoJosé RojasJuan Mauricio Pardo OviedoDario PinillaYenny CardenasEdgar CelisMario AriasAnita VukovicMaja VudragMatija BelavicJosip ZunicJanja KuharicIrena Bozanic KrickaIna Filipovic-grcicBoris TomasevicMelanija ObrazBruna BodulicaMartin DohnalJan MalaskaMilan KratochvilIgor SatinskyPeter SchwarzZdenek KosLadislav BlahutJan MacaMarek ProtusEva KieslichováLouise Gramstrup NielsenBirgitte Marianne KroghFrancisco RivadeneiraFreddy MoralesJosé MoraAlexandra Saraguro OrozcoDiego Rolando MorochotutilloNelson Remache VargasEstuardo Salgado YepezBoris VillamaguaAdel AlsisiAbdelraouf FahmyHervé DupontSigismond LasockiCatherine Paugam-burtzArnaud FoucrierAlexandru NicaGeneviève BarjonJihad MallatGuillaume MarcotteMarc LeoneGary DuclosPhilippe BurtinPhilippe MontraversEnora AtchadeYazine MahjoubBenoît MissetJean-françois TimsitClaire DupuisBenoît VeberMatthieu DebarreOliver CollangeJulien PottecherStephane HecketsweilerMélanie FromentinAntoine TesnièreChristian KochMichael SanderMatthias KottChristian EckmannGunnar ElkeHermann WriggePhilipp SimonAnthoula ChalkiadakiCharalampos TzanidakisIoannis PneumatikosEleni SertaridouZafiria MastoraIoannis PantazopoulosMetaxia PapanikolaouTheonymfi PapavasilopoulouJohn FlorosVirginia KoloniaGeorge DimopoulosChryssa DiakakiMichael RallisAlexandra ParidouAlexandros KalogeromitrosVasiliki RomanouCharikleia NikolaouKaterina KounougeriEvdoxia TsigouVasiliki PsallidaNiki KarampelaKonstantinos MandragosEftychia KontoudakiAlexandra PentheroudakiChristos Farazi-chongoukiAgathi KarakostaIsaac ChourisVasiliki RaduPolychronis MalliotakisSofia KokkiniEliana CharalambousAikaterini KyritsiVasilios KoulourasGeorgios PapathanakosEva NagkyClairi LampiriFotios TsimpoukasIoannis SarakatsanosPanagiotis GeorgakopoulosIfigeneia RavaniAthanasios PrekatesKonstantinos SakellaridisChristos ChristopoulosEfstratia VrettouKonstantinos StokkosAnastasia PentariKostoula ArvanitiKyriaki MarmanidouChristina KydonaGeorgios TsoumaropoulosMilitisa BitzaniPaschalina KontouAntonios Voudouris[Missing] Elli-nikki[Missing] FlioniElli AntypaEleftheria ChasouSouzana AnisoglouEirini PapageorgiouTheoniki ParaforouAgoritsa TsiokaAntigoni KarathanouAristeidis VakalosBhagyesh ShahChirag ThakkarNikhilesh JainMohan GurjarArvind BaroniaPrachee SatheShilpa KulkarniCherish PaulJohn PaulMansoor MasjediReza NikandishFarid ZandGolnar SabetianAta MahmoodpoorSeyed Mohammadreza HashemianMiklosh BalaRomeo FloccoSergio TorrenteVincenzo PotaSavino SpadaroCarlo VoltaMassimo GirardisGiulia SerafiniSabrina BorasoIvo TiberioAndrea CortegianiGiovanni MisseriMaria BarbagalloDavide NicolottiFrancesco ForforiFrancesco CorradiMassimo AntonelliGennaro De PascaleLorella PelagalliLuca BrazziFerdinando Giorgio VittoneAlessandro RussoDavide SimionAntonella CotoiaGilda CinnellaPatrick ToppinRoxanne Johnson-jacksonYoshiro HayashiRyohei YamamotoHideto YasudaYuki KishiharaJunji ShiotsukaLuis Alejandro Sanchez-hurtadoBrigitte Tejeda-huezoLuis GorordoSilvio A. ÑAmendys-silvaFrancisco J. Garcia-guillenManuel MartinezErick Romero-mejaEver Colorado-dominguezHuub Van Den OeverKarel Martijn KalffWytze VermeijdenAlexander Daniel CornetOliver BeckNedim CimicTom DormansLaura BormansJan BakkerDitty Van DuijnGerrit BosmanPiet VosDylan De LangeLenneke HaasAkram HeneinAriel M. MirandaLuis Daniel Umezawa MakikadoGonzalo Ernesto Gianella MalcaAbel Arroyo-sanchezAgnieszka Misiewska-kaczurFrisch AkinyiMiroslaw CzuczwarKarolina LuczakWiktor SulkowskiBarbara TamowiczAdam MikstackiBeata SwitBronisław BaranowskiPiotr SmuszkiewiczIwona TrojanowskaStanislaw RzymskiMariusz SawinskiMarta TrosiakMalgorzata Mikaszewska-sokolewiczRicardo AlvesDina LealAndriy KrystopchukPedro Muguel Hilario MendoncaRui Antunes PereiraMaria Raquel Lopes Marques De CarvalhoCarlos CandeiasElena MolinosAmélia FerreiraGuiomar CastroJosé-artur PaivaJosé-manuel PereiraLurdes SantosAlcina FerreiraDulce PascoalinhoRosa RibeiroGuilherme DomingosPedro GomesDavid NoraRui Pedro CostaAnabela SantosAhmed Subhy AlsheikhlyDana TomescuMihai PopescuIoana GrigorasEmilia PatrascanuIgor ZabolotskikhTatiana MusaevaAlexey GritsanDenis GaigolnikVladimir KulabukhovVladislav BelskiyNadezhda ZubarevaMaxim TribulevAhmed AbdelsalamAyman AldarsaniMuhammad Al-khalidGhaleb AlmekhlafiYasser MandourahBojan JovanovicKrstina DoklesticJelena VelickovicDejan VelickovicRadmilo JankovicAnita VukovicSvetlana Skoric-jokicDragana RadovanovicGuy RichardsAhmad AlliMaria Del Carmen Cordoba NielfaRafael Sánchez IniestaAdela Benítez-cano MartínezCarlos Garcia BernedoSantiago Alberto Picos GilXavier NuvialsJordi RelloJoseba Gonzalez GarciaJose Manuel Garcia PeñaRoberto JimenezLuis HerreraLaura Galarza BarrachinaIgnacio Catalan MonzonFrancisco Javier RedondoRuben VillazalaDiego Fernando Matallana ZapataIsabel Maria Villa LopezGabriel Moreno-gonzalezJuan Carlos Lopez-delgadoJorge Solera MarinPurificacion Sanchez-zamoraMontserrat Vallverdú VidalJesús Flores GonzálezIrene SalinasCecilia HermosaEmilio MasedaFernando Martinez-sagastiSara Domingo-marínJohanna Abril VictorinoRaquel Garcia-alvarezPablo López-arcas CallejaMaria-victoria De La Torre-pradosPablo Vidal-cortesLorena Del Río-carbajoJavier IzuraVictoria MinguezJosep Trenado AlvarezAnna Parera ProusDaniel PazFerran Roche-campoGerardo AguilarJavier BeldaJesus Rico-feijooCesat AldecoaBegoña Zalba-etayoMartin LangAlexander DullenkopfKonlawij TrongtrakulAnusang ChtsomkasemTürkay AkbaşMustafa Necmettin UnalMenekse OzcelikAyca GumusAtilla RamazanogluDilek MemisInal MehmetYalim DikmenSeval UrkmezAsu OzgultekinOktay DemirkiranNesrin Ahu AslanDeniz KizilaslanFerda KahveciNurdan ÜNlüZeynep OzkanCallum KayeJan JansenOrla O’neillChristopher NuttRajeev JhaNicolas HookerIrina GrecuChristina PetridouMurali ShyamsundarLia McnameeJohn TrinderSamantha HaganCatriona KellyJonathon SilversidesCasiano Barrera GrobaOwen BoydKaushik BhowmickSally HumphreysCharlotte SummersPetra PolgarovaMichael MargarsonJustin DickensSuzanne PearsonElaine ChineryNoel HemmingsSinead O’kanePauline AustinStephen ColeCatherine PlowrightRoberta BoxChristopher WrightLorna YoungBen Creagh-brownLaura MontagueRobert ParkerBen MortonMarlies OstermannJulia BilinskaBernd Oliver RoseRosie Reece-anthonyChristine RyanMark HamiltonPhilip HopkinsJulia WendonGiovanni BresciaNazia IjazJames WoodMichelle GeorgePiroska Toth-tarsolyBryan YatesMaureen ArmstrongCarmen ScottChristine BoydTamas SzakmanyDavid ReesPaul PulakMandy CoggonBhaskar SahaLinda KentBethan GibsonJulie CamsooksaiHenrik ReschreiterPat MorganSivatharshini SangaralinghamAlastair LowePetr VondrasSunil JamadarkhanaCarina CruzRakesh BhandaryPeter HerseyJulie FurnevalRichard InnesPatricia DobleBen AttwoodPenny ParsonsValerie PageXiaobei ZhaoIrina GrecuJulian DaltonMohammed HegazyYasser AwadDouglas NaylorAmanda NaylorSarah LeeSidney BrevardNoelle Davis[Missing] For The Abdominal Sepsis Study (‘Abses’) Group On Behalf Of The Trials Group Of The European Society Of Intensive Care Medicinesubject
Drug Resistancemedicine.disease_causeSeverity of Illness Indexlaw.invention0302 clinical medicineENTEROBACTERIACEAElawDrug Resistance Multiple BacterialMedicine and Health SciencesPharmacology (medical)Cross InfectionbiologyBacterialAntimicrobialIntensive care unitAnti-Bacterial AgentsCommunity-Acquired InfectionsEuropeIntensive Care UnitsAnti-Bacterial Agents; Community-Acquired Infections; Critical Illness; Cross Infection; Europe; Humans; Intensive Care Units; Intraabdominal Infections; Microbial Sensitivity Tests; Peritonitis; Sepsis; Severity of Illness Index; Drug Resistance Multiple BacterialESCHERICHIA-COLI030220 oncology & carcinogenesisKLEBSIELLA-PNEUMONIAEBLOOD-STREAM INFECTIONSPYELONEPHRITISMultiplemedicine.medical_specialtyCritical IllnessMicrobial Sensitivity TestsPeritonitisEnterococcus faecalisNO03 medical and health sciencesIntra‑abdominal InfectionsAntibiotic resistanceFOODSepsisIntensive careInternal medicinemedicineHumansFLUOROQUINOLONE RESISTANCEPseudomonas aeruginosabusiness.industrySeptic shockMORTALITYbiology.organism_classificationmedicine.diseaseRISK-FACTORSIntraabdominal Infectionsbusiness030217 neurology & neurosurgeryEnterococcus faeciumdescription
Severe intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. In this study, we report on resistance profiles of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis and Enterococcus faecium in distinct European geographic regions based on an observational cohort study on intra-abdominal infections in intensive care unit (ICU) patients. Resistance against aminopenicillins, fluoroquinolones, and third-generation cephalosporins in E. coli, K. pneumoniae and P. aeruginosa is problematic, as is carbapenem-resistance in the latter pathogen. For E. coli and K. pneumoniae, resistance is mainly an issue in Central Europe, Eastern and South-East Europe, and Southern Europe, while resistance in P. aeruginosa is additionally problematic in Western Europe. Vancomycin-resistance in E. faecalis is of lesser concern but requires vigilance in E. faecium in Central and Eastern and South-East Europe. In the subcohort of patients with secondary peritonitis presenting with either sepsis or septic shock, the appropriateness of empiric antimicrobial therapy was not associated with mortality. In contrast, failure of source control was strongly associated with mortality. The relevance of these new insights for future recommendations regarding empiric antimicrobial therapy in intra-abdominal infections is discussed.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-05-26 |