Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project

• Type: Article in International Scientific Journal
• Date: 2019

Authors

Blot, S (Author) Other; Antonelli, M (Author) Other; Arvaniti, K (Author) Other; Blot, K (Author) Other; Creagh Brown, B (Author) Other; de Lange, D (Author) Other; De Waele, J (Author) Other; Deschepper, M (Author) Other; Dikmen, Y (Author) Other; Dimopoulos, G (Author) Other; Eckmann, C (Author) Other; Francois, G (Author) Other; Girardis, M (Author) Other; Koulenti, D (Author) Other; Labeau, S (Author) Other; Lipman, J (Author) Other; Lipovestky, F (Author) Other; Maseda, E (Author) Other; Montravers, P (Author) Other; Mikstacki, A (Author) Other; Paiva, J-A (Author) FMUP; Pereyra, C (Author) Other; Rello, J (Author) Other; Timsit, JF (Author) Other; Vogelaers, D (Author) Other; Lamrous, A (Author) Other; Rezende Neto, J (Author) Other; Cardenas, Y (Author) Other; Vymazal, T (Author) Other; Fjeldsoee Nielsen, H (Author) Other; Kott, M (Author) Other; Kostoula, A (Author) Other; Javeri, Y (Author) Other; Einav, S (Author) Other; Makikado, LDU (Author) Other; Tomescu, D (Author) Other; Gritsan, A (Author) Other; Jovanovic, B (Author) Other; Venkatesan, K (Author) Other; Mirkovic, T (Author) Other; Creagh Brown, B (Author) Other; Emmerich, M (Author) Other; Canale, M (Author) Other; Dietz, LS (Author) Other; Ilutovich, S (Author) Other; Minope, JTS (Author) Other; Silva, RB (Author) Other; Montenegro, MA (Author) Other; Martin, P (Author) Other; Saul, P (Author) Other; Chediack, V (Author) Other; Sutton, G (Author) Other; Couce, R (Author) Other; Balasini, C (Author) Other; Gonzalez, S (Author) Other; Lascar, FM (Author) Other; Descotte, EJ (Author) Other; Gumiela, NS (Author) Other; Pino, CA (Author) Other; Cesio, C (Author) Other; Valgolio, E (Author) Other; Cunto, E (Author) Other; Dominguez, C (Author) Other; Nelson, NF (Author) Other; Abegao, EM (Author) Other; Pozo, NC (Author) Other; Bianchi, L (Author) Other; Correger, E (Author) Other; Pastorino, ML (Author) Other; Miyazaki, EA (Author) Other; Grubissich, N (Author) Other; Garcia, M (Author) Other; Bonetto, N (Author) Other; Quevedo, NE (Author) Other; Gomez, CD (Author) Other; Queti, F (Author) Other; Estevarena, LG (Author) Other; Cruz, G (Author) Other; Fernandez, R (Author) Other; Santolaya, I (Author) Other; Grangeat, SH (Author) Other; Doglia, J (Author) Other; Zakalik, G (Author) Other; Pellegrini, C (Author) Other; Lloria, MM (Author) Other; Chacon, ME (Author) Other; Fumale, M (Author) Other; Leguizamon, M (Author) Other; Hidalgo, IB (Author) Other; Tiranti, RJ (Author) Other; Capponi, P (Author) Other; Tita, A (Author) Other; Cardonnet, L (Author) Other; Bettini, L (Author) Other; Ramos, A (Author) Other; Lovesio, L (Author) Other; Miranda, EM (Author) Other; Farfan, AB (Author) Other; Tolosa, C (Author) Other; Segura, L (Author) Other; Bellocchio, A (Author) Other; Alvarez, B (Author) Other; Manzur, A (Author) Other; Lujan, R (Author) Other; Fernandez, N (Author) Other; Scarone, N (Author) Other; Zazu, A (Author) Other; Groh, C (Author) Other; Fletcher, J (Author) Other; Smith, J (Author) Other; Azad, R (Author) Other; Chavan, N (Author) Other; Wong, H (Author) Other; Kol, M (Author) Other; Campbell, L (Author) Other; Starr, T (Author) Other; Roberts, B (Author) Other; Wibrow, B (Author) Other; Warhurst, T (Author) Other; Chinthamuneedi, M (Author) Other; Ferney, BB (Author) Other; Simon, M (Author) Other; De Backer, D (Author) Other; Wittebole, X (Author) Other; De Bels, D (Author) Other; Collin, V (Author) Other; Dams, K (Author) Other; Jorens, P (Author) Other; Dubois, J (Author) Other; Gunst, J (Author) Other; Haentjens, L (Author) Other; De Schryver, N (Author) Other; Dugernier, T (Author) Other; Rizoli, S (Author) Other; Santillan, P (Author) Other; Han, Y (Author) Other; Biskup, E (Author) Other; Qu, CJ (Author) Other; Li, XY (Author) Other; Yu, T (Author) Other; Lu, WH (Author) Other; Molano Franco, D (Author) Other; Rojas, J (Author) Other; Oviedo, JMP (Author) Other; Pinilla, D (Author) Other; Celis, E (Author) Other; Arias, M (Author) Other; Vukovic, A (Author) Other; Vudrag, M (Author) Other; Belavic, M (Author) Other; Zunic, J (Author) Other; Kuharic, J (Author) Other; Kricka, IB (Author) Other; Filipovic Grcic, I (Author) Other; Tomasevic, B (Author) Other; Obraz, M (Author) Other; Bodulica, B (Author) Other; Dohnal, M (Author) Other; Malaska, J (Author) Other; Kratochvil, M (Author) Other; Satinsky, I (Author) Other; Schwarz, P (Author) Other; Kos, Z (Author) Other; Blahut, L (Author) Other; Maca, J (Author) Other; Protus, M (Author) Other; Kieslichova, E (Author) Other; Nielsen, LG (Author) Other; Krogh, BM (Author) Other; Rivadeneira, F (Author) Other; Morales, F (Author) Other; Mora, J (Author) Other; Orozco, AS (Author) Other; MorochoTutillo, DR (Author) Other; Vargas, NR (Author) Other; Yepez, ES (Author) Other; Villamagua, B (Author) Other; Alsisi, A (Author) Other; Fahmy, A (Author) Other; Dupont, H (Author) Other; Lasocki, S (Author) Other; Paugam Burtz, C (Author) Other; Foucrier, A (Author) Other; Nica, A (Author) Other; Barjon, G (Author) Other; Mallat, J (Author) Other; Marcotte, G (Author) Other; Leone, M (Author) Other; Duclos, G (Author) Other; Burtin, P (Author) Other; Atchade, E (Author) Other; Mahjoub, Y (Author) Other; Misset, B (Author) Other; Dupuis, C (Author) Other; Veber, B (Author) Other; Debarre, M (Author) Other; Collange, O (Author) Other; Pottecher, J (Author) Other; Hecketsweiler, S (Author) Other; Fromentin, M (Author) Other; Tesniere, A (Author) Other; Koch, C (Author) Other; Sander, M (Author) Other; Elke, G (Author) Other; Wrigge, H (Author) Other; Simon, P (Author) Other; Chalkiadaki, A (Author) Other; Tzanidakis, C (Author) Other; Pneumatikos, I (Author) Other; Sertaridou, E (Author) Other; Mastora, Z (Author) Other; Pantazopoulos, I (Author) Other; Papanikolaou, M (Author) Other; Papavasilopoulou, T (Author) Other; Floros, J (Author) Other; Kolonia, V (Author) Other; Diakaki, C (Author) Other; Rallis, M (Author) Other; Paridou, A (Author) Other; Kalogeromitros, A (Author) Other; Romanou, V (Author) Other; Nikolaou, C (Author) Other; Kounougeri, K (Author) Other; Tsigou, E (Author) Other; Psallida, V (Author) Other; Karampela, N (Author) Other; Mandragos, K (Author) Other; Kontoudaki, E (Author) Other; Pentheroudaki, A (Author) Other; Farazi Chongouki, C (Author) Other; Karakosta, A (Author) Other; Chouris, I (Author) Other; Radu, V (Author) Other; Malliotakis, P (Author) Other; Kokkini, S (Author) Other; Charalambous, E (Author) Other; Kyritsi, A (Author) Other; Koulouras, V (Author) Other; Papathanakos, G (Author) Other; Naglry, E (Author) Other; Lampiri, C (Author) Other; Tsimpoukas, F (Author) Other; Sarakatsanos, I (Author) Other; Georgakopoulos, P (Author) Other; Ravani, I (Author) Other; Prekates, A (Author) Other; Sakellaridis, K (Author) Other; Christopoulos, C (Author) Other; Vrettou, E (Author) Other; Stokkos, K (Author) Other; Pentari, A (Author) Other; Marmanidou, K (Author) Other; Kydona, C (Author) Other; Tsoumaropoulos, G (Author) Other; Bitzani, M (Author) Other; Kontou, P (Author) Other; Voudouris, A (Author) Other; Elli Nikki (Author) Other; Flioni (Author) Other; Antypa, E (Author) Other; Chasou, E (Author) Other; Anisoglou, S (Author) Other; Papageorgiou, E (Author) Other; Paraforou, T (Author) Other; Tsioka, A (Author) Other; Karathanou, A (Author) Other; Vakalos, A (Author) Other; Shah, B (Author) Other; Thakkar, C (Author) Other; Jain, N (Author) Other; Gurjar, M (Author) Other; Baronia, A (Author) Other; Sathe, P (Author) Other; Kulkarni, S (Author) Other; Paul, C (Author) Other; Paul, J (Author) Other; Masjedi, M (Author) Other; Nikandish, R (Author) Other; Land, F (Author) Other; Sabetian, G (Author) Other; Mahmoodpoor, A (Author) Other; Hashemian, SM (Author) Other; Bala, M (Author) Other; Flocco, R (Author) Other; Torrente, S (Author) Other; Pota, V (Author) Other; Spadaro, S (Author) Other; Volta, C (Author) Other; Serafini, G (Author) Other; Boraso, S (Author) Other; Tiberio, I (Author) Other; Cortegiani, A (Author) Other; Misseri, G (Author) Other; Barbagallo, M (Author) Other; 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Journal

Title: Intensive Care Medicine

Vol. 45

Pages: 1703-1717

ISSN: 0342-4642

Publisher: Springer Nature

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ISI Web of Knowledge - 10 Citations

Scopus - 19 Citations

Other information

Authenticus ID: P-00R-ED6

DOI: 10.1007/s00134-019-05819-3

Abstract (EN): 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.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 15