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

Επιστημονική δημοσίευση - Άρθρο Περιοδικού uoadl:3105397 126 Αναγνώσεις

Μονάδα:
Ερευνητικό υλικό ΕΚΠΑ
Τίτλος:
Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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).
Έτος δημοσίευσης:
2019
Συγγραφείς:
Blot, S.
Antonelli, M.
Arvaniti, K.
Blot, K.
Creagh-Brown, B.
de Lange, D.
De Waele, J.
Deschepper, M.
Dikmen, Y.
Dimopoulos, G.
Eckmann, C.
Francois, G.
Girardis, M.
Koulenti, D.
Labeau, S.
Lipman, J.
Lipovestky, F.
Maseda, E.
Montravers, P.
Mikstacki, A.
Paiva, J.-A.
Pereyra, C.
Rello, J.
Timsit, J.-F.
Vogelaers, D.
Lamrous, A.
Rezende-Neto, J.
Cardenas, Y.
Vymazal, T.
Fjeldsoee-Nielsen, H.
Kott, M.
Kostoula, A.
Javeri, Y.
Einav, S.
Makikado, L.D.U.
Tomescu, D.
Gritsan, A.
Jovanovic, B.
Venkatesan, K.
Mirkovic, T.
Creagh-Brown, B.
Lamrous, A.
Emmerich, M.
Canale, M.
Dietz, L.S.
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Miñope, J.T.S.
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Montenegro, M.A.
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Sutton, G.
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Balasini, C.
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Pino, C.A.
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Valgolio, E.
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Dominguez, C.
Nelson, N.F.
Abegao, E.M.
Pozo, N.C.
Bianchi, L.
Correger, E.
Pastorino, M.L.
Miyazaki, E.A.
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Grubissich, N.
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Humphreys, S.
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Polgarova, P.
Margarson, M.
Dickens, J.
Pearson, S.
Chinery, E.
Hemmings, N.
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Austin, P.
Cole, S.
Plowright, C.
Box, R.
Wright, C.
Young, L.
Montague, L.
Parker, R.
Morton, B.
Ostermann, M.
Bilinska, J.
Rose, B.O.
Reece-Anthony, R.
Ryan, C.
Hamilton, M.
Hopkins, P.
Wendon, J.
Brescia, G.
Ijaz, N.
Wood, J.
George, M.
Toth-Tarsoly, P.
Yates, B.
Armstrong, M.
Scott, C.
Boyd, C.
Szakmany, T.
Rees, D.
Pulak, P.
Coggon, M.
Saha, B.
Kent, L.
Gibson, B.
Camsooksai, J.
Reschreiter, H.
Morgan, P.
Sangaralingham, S.
Lowe, A.
Vondras, P.
Jamadarkhana, S.
Cruz, C.
Bhandary, R.
Hersey, P.
Furneval, J.
Innes, R.
Doble, P.
Attwood, B.
Parsons, P.
Page, V.
Zhao, X.
Grecu, I.
Dalton, J.
Hegazy, M.
Awad, Y.
Naylor, D.
Naylor, A.
Lee, S.
Brevard, S.
Davis, N.
the Abdominal Sepsis Study (AbSeS) group on behalf of the Trials Group of the European Society of Intensive Care Medicine
Περιοδικό:
Intensive Care Medicine Experimental
Εκδότης:
Springer Science and Business Media Deutschland GmbH
Τόμος:
45
Αριθμός / τεύχος:
12
Σελίδες:
1703-1717
Λέξεις-κλειδιά:
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
Επίσημο URL (Εκδότης):
DOI:
10.1007/s00134-019-05819-3
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