Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM trials group project

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dc.authorid0000-0003-4901-6006
dc.authorid0000-0001-6587-8103
dc.contributor.authorBlot, Stijn
dc.contributor.authorAntonelli, Massimo
dc.contributor.authorArvaniti, Kostoula
dc.contributor.authorBlot, Koen
dc.contributor.authorCreagh Brown, Ben
dc.contributor.authorde Lange, Dylan
dc.contributor.authorDe Waele, Jan
dc.contributor.authorDeschepper, Mieke
dc.contributor.authorDikmen, Yalim
dc.contributor.authorDimopoulos, George
dc.contributor.authorEckmann, Christian
dc.contributor.authorFrancois, Guy
dc.contributor.authorGirardis, Massimo
dc.contributor.authorKoulenti, Despoina
dc.contributor.authorLabeau, Sonia
dc.contributor.authorLipman, Jeffrey
dc.contributor.authorLipovestky, Fernando
dc.contributor.authorMaseda, Emilio
dc.contributor.authorMontravers, Philippe
dc.contributor.authorMikstacki, Adam
dc.contributor.authorPaiva, Jose Artur
dc.contributor.authorPereyra, Cecilia
dc.contributor.authorRello, Jordi
dc.contributor.authorTimsit, Jean, Francois
dc.contributor.authorVogelaers, Dirk
dc.contributor.authorAslan, Nesrin Ahu
dc.contributor.authorKızılaslan, Deniz
dc.date.accessioned2019-12-20T12:44:02Z
dc.date.available2019-12-20T12:44:02Z
dc.date.issued2019
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
dc.description.abstractPurposeTo 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.
dc.identifier.citationBlot, S., Antonelli, M., Arvaniti, K., Blot, K., Creagh Brown, Ben., Lange, D. ... Kızılaslan, D. (2019). Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM trials group project. Intensive Care Medicine, 45(12), 1703-1717. https://doi.org/10.1007/s00134-019-05819-3
dc.identifier.doi10.1007/s00134-019-05819-3
dc.identifier.endpage1717
dc.identifier.issn0342-4642
dc.identifier.issn1432-1238
dc.identifier.issue12
dc.identifier.scopusqualityQ1
dc.identifier.startpage1703
dc.identifier.urihttps://doi.org/10.1007/s00134-019-05819-3
dc.identifier.urihttps://hdl.handle.net/20.500.12511/4583
dc.identifier.volume45
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofIntensive Care Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution-NonCommercial 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/*
dc.subjectIntra-Abdominal Infection
dc.subjectPeritonitis
dc.subjectSepsis
dc.subjectIntensive Care
dc.subjectMultidrug Resistance
dc.subjectMortality
dc.titleEpidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM trials group project
dc.typeArticle

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