@article{3105397,
    title = "Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project",
    author = "Blot, S. and Antonelli, M. and Arvaniti, K. and Blot, K. and Creagh-Brown, B. and de Lange, D. and De Waele, J. and Deschepper, M. and Dikmen, Y. and Dimopoulos, G. and Eckmann, C. and Francois, G. and Girardis, M. and Koulenti, D. and Labeau, S. and Lipman, J. and Lipovestky, F. and Maseda, E. and Montravers, P. and Mikstacki, A. and Paiva, J.-A. and Pereyra, C. and Rello, J. and Timsit, J.-F. and Vogelaers, D. and Lamrous, A. and Rezende-Neto, J. and Cardenas, Y. and Vymazal, T. and Fjeldsoee-Nielsen, H. and Kott, M. and Kostoula, A. and Javeri, Y. and Einav, S. and Makikado, L.D.U. and Tomescu, D. and Gritsan, A. and Jovanovic, B. and Venkatesan, K. and Mirkovic, T. and Creagh-Brown, B. and Lamrous, A. and Emmerich, M. and Canale, M. and Dietz, L.S. and Ilutovich, S. and Miñope, J.T.S. and Silva, R.B. and Montenegro, M.A. and Martin, P. and Saul, P. and Chediack, V. and Sutton, G. and Couce, R. and Balasini, C. and Gonzalez, S. and Lascar, F.M. and Descotte, E.J. and Gumiela, N.S. and Pino, C.A. and Cesio, C. and Valgolio, E. and Cunto, E. and Dominguez, C. and Nelson, N.F. and Abegao, E.M. and Pozo, N.C. and Bianchi, L. and Correger, E. and Pastorino, M.L. and Miyazaki, E.A. and Pozo, N.C. and Grubissich, N. and Garcia, M. and Bonetto, N. and Quevedo, N.E. and Gomez, C.D. and Queti, F. and Estevarena, L.G. and Fernandez, R. and Santolaya, I. and Pozo, N.C. and Grangeat, S.H. and Doglia, J. and Zakalik, G. and Pellegrini, C. and Lloria, M.M. and Chacon, M.E. and Fumale, M. and Leguizamon, M. and Hidalgo, I.B. and Tiranti, R.J. and Capponi, P. and Tita, A. and Cardonnet, L. and Bettini, L. and Ramos, A. and Lovesio, L. and Miranda, E.M. and Farfan, A.B. and Tolosa, C. and Segura, L. and Bellocchio, A. and Alvarez, B. and Manzur, A. and Lujan, R. and Fernandez, N. and Scarone, N. and Zazu, A. and Groh, C. and Fletcher, J. and Smith, J. and Azad, R. and Chavan, N. and Wong, H. and Kol, M. and Campbell, L. and Starr, T. and Roberts, B. and Wibrow, B. and Warhurst, T. and Chinthamuneedi, M. and Ferney, B.B. and Simon, M. and De Backer, D. and Wittebole, X. and De Bels, D. and Collin, V. and Dams, K. and Jorens, P. and Dubois, J. and Gunst, J. and Haentjens, L. and De Schryver, N. and Dugernier, T. and Rezende-Neto, J. and Rizoli, S. and Santillan, P. and Han, Y. and Biskup, E. and Qu, C. and Li, X. and Yu, T. and Weihua, L. and Molano-Franco, D. and Rojas, J. and Oviedo, J.M.P. and Pinilla, D. and Cardenas, Y. and Celis, E. and Arias, M. and Vukovic, A. and Vudrag, M. and Belavic, M. and Zunic, J. and Kuharic, J. and Kricka, I.B. and Filipovic-Grcic, I. and Tomasevic, B. and Obraz, M. and Bodulica, B. and Dohnal, M. and Malaska, J. and Kratochvil, M. and Satinsky, I. and Schwarz, P. and Kos, Z. and Blahut, L. and Maca, J. and Protus, M. and Kieslichová, E. and Nielsen, L.G. and Krogh, B.M. and Rivadeneira, F. and Morales, F. and Mora, J. and Orozco, A.S. and MorochoTutillo, D.R. and Vargas, N.R. and Yepez, E.S. and Villamagua, B. and Alsisi, A. and Fahmy, A. and Dupont, H. and Lasocki, S. and Paugam-Burtz, C. and Foucrier, A. and Nica, A. and Barjon, G. and Mallat, J. and Marcotte, G. and Leone, M. and Duclos, G. and Burtin, P. and Atchade, E. and Mahjoub, Y. and Misset, B. and Timsit, J.-F. and Dupuis, C. and Veber, B. and Debarre, M. and Collange, O. and Pottecher, J. and Hecketsweiler, S. and Fromentin, M. and Tesnière, A. and Koch, C. and Sander, M. and Kott, M. and Elke, G. and Wrigge, H. and Simon, P. and Chalkiadaki, A. and Tzanidakis, C. and Pneumatikos, I. and Sertaridou, E. and Mastora, Z. and Pantazopoulos, I. and Papanikolaou, M. and Papavasilopoulou, T. and Floros, J. and Kolonia, V. and Diakaki, C. and Rallis, M. and Paridou, A. and Kalogeromitros, A. and Romanou, V. and Nikolaou, C. and Kounougeri, K. and Tsigou, E. and Psallida, V. and Karampela, N. and Mandragos, K. and Kontoudaki, E. and Pentheroudaki, A. and Farazi-Chongouki, C. and Karakosta, A. and Chouris, I. and Radu, V. and Malliotakis, P. and Kokkini, S. and Charalambous, E. and Kyritsi, A. and Koulouras, V. and Papathanakos, G. and Nagky, E. and Lampiri, C. and Tsimpoukas, F. and Sarakatsanos, I. and Georgakopoulos, P. and Ravani, I. and Prekates, A. and Sakellaridis, K. and Christopoulos, C. and Vrettou, E. and Stokkos, K. and Pentari, A. and Marmanidou, K. and Kydona, C. and Tsoumaropoulos, G. and Bitzani, M. and Kontou, P. and Voudouris, A. and Elli-Nikki and Flioni and Antypa, E. and Chasou, E. and Anisoglou, S. and Papageorgiou, E. and Paraforou, T. and Tsioka, A. and Karathanou, A. and Vakalos, A. and Shah, B. and Thakkar, C. and Jain, N. and Gurjar, M. and Baronia, A. and Sathe, P. and Kulkarni, S. and Paul, C. and Paul, J. and Masjedi, M. and Nikandish, R. and Zand, F. and Sabetian, G. and Mahmoodpoor, A. and Hashemian, S.M. and Bala, M. and Flocco, R. and Torrente, S. and Pota, V. and Spadaro, S. and Volta, C. and Serafini, G. and Boraso, S. and Tiberio, I. and Cortegiani, A. and Misseri, G. and Barbagallo, M. and Nicolotti, D. and Forfori, F. and Corradi, F. and De Pascale, G. and Pelagalli, L. and Brazzi, L. and Vittone, F.G. and Russo, A. and Simion, D. and Cotoia, A. and Cinnella, G. and Toppin, P. and Johnson-Jackson, R. and Hayashi, Y. and Yamamoto, R. and Yasuda, H. and Kishihara, Y. and Shiotsuka, J. and Sanchez-Hurtado, L.A. and Tejeda-Huezo, B. and Gorordo, L. and Ñamendys-Silva, S.A. and Garcia-Guillen, F.J. and Martinez, M. and Romero-Meja, E. and Colorado-Dominguez, E. and van den Oever, H. and Kalff, K.M. and Vermeijden, W. and Cornet, A.D. and Beck, O. and Cimic, N. and Dormans, T. and Bormans, L. and Bakker, J. and Van Duijn, D. and Bosman, G. and Vos, P. and Haas, L. and Henein, A. and Miranda, A.M. and Makikado, L.D.U. and Malca, G.E.G. and Arroyo-Sanchez, A. and Misiewska-Kaczur, A. and Akinyi, F. and Czuczwar, M. and Luczak, K. and Sulkowski, W. and Tamowicz, B. and Swit, B. and Baranowski, B. and Smuszkiewicz, P. and Trojanowska, I. and Rzymski, S. and Sawinski, M. and Trosiak, M. and Mikaszewska-Sokolewicz, M. and Alves, R. and Leal, D. and Krystopchuk, A. and Mendonca, P.M.H. and Pereira, R.A. and de Carvalho, M.R.L.M. and Candeias, C. and Molinos, E. and Ferreira, A. and Castro, G. and Pereira, J.-M. and Santos, L. and Ferreira, A. and Pascoalinho, D. and Ribeiro, R. and Domingos, G. and Gomes, P. and Nora, D. and Costa, R.P. and Santos, A. and Alsheikhly, A.S. and Tomescu, D. and Popescu, M. and Grigoras, I. and Patrascanu, E. and Zabolotskikh, I. and Musaeva, T. and Gaigolnik, D. and Kulabukhov, V. and Belskiy, V. and Zubareva, N. and Tribulev, M. and Abdelsalam, A. and Aldarsani, A. and Al-Khalid, M. and Almekhlafi, G. and Mandourah, Y. and Jovanovic, B. and Doklestic, K. and Velickovic, J. and Velickovic, D. and Jankovic, R. and Vukovic, A. and Skoric-Jokic, S. and Radovanovic, D. and Richards, G. and Alli, A. and del Carmen Cordoba Nielfa, M. and Iniesta, R.S. and Martínez, A.B.-C. and Bernedo, C.G. and Gil, S.A.P. and Nuvials, X. and Garcia, J.G. and Peña, J.M.G. and Jimenez, R. and Herrera, L. and Barrachina, L.G. and Monzon, I.C. and Redondo, F.J. and Villazala, R. and Zapata, D.F.M. and Lopez, I.M.V. and Moreno-Gonzalez, G. and Lopez-Delgado, J.C. and Marin, J.S. and Sanchez-Zamora, P. and Vidal, M.V. and González, J.F. and Salinas, I. and Hermosa, C. and Martinez-Sagasti, F. and Domingo-Marín, S. and Victorino, J.A. and Garcia-Alvarez, R. and Calleja, P.L.-A. and de la Torre-Prados, M.-V. and Vidal-Cortes, P. and del Río-Carbajo, L. and Izura, J. and Minguez, V. and Alvarez, J.T. and Prous, A.P. and Paz, D. and Roche-Campo, F. and Aguilar, G. and Belda, J. and Rico-Feijoo, J. and Aldecoa, C. and Zalba-Etayo, B. and Lang, M. and Dullenkopf, A. and Trongtrakul, K. and Chtsomkasem, A. and Akbas, T. and Unal, M.N. and Ozcelik, M. and Gumus, A. and Ramazanoglu, A. and Memis, D. and Mehmet, I. and Urkmez, S. and Ozgultekin, A. and Demirkiran, O. and Aslan, N.A. and Kizilaslan, D. and Kahveci, F. and Ünlü, N. and Ozkan, Z. and Kaye, C. and Jansen, J. and O’Neill, O. and Nutt, C. and Jha, R. and Hooker, N. and Grecu, I. and Petridou, C. and Shyamsundar, M. and McNamee, L. and Trinder, J. and Hagan, S. and Kelly, C. and Silversides, J. and Groba, C.B. and Boyd, O. and Bhowmick, K. and Humphreys, S. and Summers, C. and Polgarova, P. and Margarson, M. and Dickens, J. and Pearson, S. and Chinery, E. and Hemmings, N. and O’Kane, S. and Austin, P. and Cole, S. and Plowright, C. and Box, R. and Wright, C. and Young, L. and Montague, L. and Parker, R. and Morton, B. and Ostermann, M. and Bilinska, J. and Rose, B.O. and Reece-Anthony, R. and Ryan, C. and Hamilton, M. and Hopkins, P. and Wendon, J. and Brescia, G. and Ijaz, N. and Wood, J. and George, M. and Toth-Tarsoly, P. and Yates, B. and Armstrong, M. and Scott, C. and Boyd, C. and Szakmany, T. and Rees, D. and Pulak, P. and Coggon, M. and Saha, B. and Kent, L. and Gibson, B. and Camsooksai, J. and Reschreiter, H. and Morgan, P. and Sangaralingham, S. and Lowe, A. and Vondras, P. and Jamadarkhana, S. and Cruz, C. and Bhandary, R. and Hersey, P. and Furneval, J. and Innes, R. and Doble, P. and Attwood, B. and Parsons, P. and Page, V. and Zhao, X. and Grecu, I. and Dalton, J. and Hegazy, M. and Awad, Y. and Naylor, D. and Naylor, A. and Lee, S. and Brevard, S. and Davis, N. and the Abdominal Sepsis Study (AbSeS) group on behalf of the Trials Group of the European Society of Intensive Care Medicine",
    journal = "Intensive Care Medicine Experimental",
    year = "2019",
    volume = "45",
    number = "12",
    pages = "1703-1717",
    publisher = "Springer Science and Business Media Deutschland GmbH",
    issn = "2197-425X",
    doi = "10.1007/s00134-019-05819-3",
    keywords = "antibiotic agent;  antifungal agent, abdominal abscess;  abdominal infection;  adult;  aged;  antibiotic resistance;  antibiotic therapy;  antifungal therapy;  Article;  biliary tract infection;  carbapenem resistance;  cohort analysis;  community acquired infection;  congestive heart failure;  critically ill patient;  female;  hospital infection;  human;  infection risk;  late onset disorder;  liver failure;  major clinical study;  male;  malnutrition;  methicillin resistant Staphylococcus aureus;  mortality;  multicenter study;  observational study;  pancreas disease;  peritoneal dialysis;  peritonitis;  predictive value;  prevalence;  sepsis;  septic shock;  toxic megacolon;  typhlitis;  vancomycin resistant Enterococcus;  abdominal infection;  cause of death;  clinical trial;  critical illness;  middle aged;  mortality;  risk factor;  sepsis, Aged;  Cause of Death;  Cohort Studies;  Critical Illness;  Epidemiologic Studies;  Female;  Humans;  Intraabdominal Infections;  Male;  Middle Aged;  Risk Factors;  Sepsis",
    abstract = "Purpose: To 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). Methods: We 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. Results: The 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. Conclusion: This 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. © 2019, The Author(s)."
}