Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project
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), anatomica...
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| Veröffentlicht in: | INTENSIVE CARE MEDICINE 2019-10, Vol.45 (12), p.1703-1717 |
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| creator | Blot, Stijn Antonelli, Massimo Arvaniti, Kostoula Blot, Koen Creagh-Brown, Ben de Lange, Dylan De Waele, Jan Deschepper, Mieke Dikmen, Yalim Dimopoulos, George Eckmann, Christian Francois, Guy Girardis, Massimo Koulenti, Despoina Labeau, Sonia Lipman, Jeffrey Lipovestky, Fernando Maseda, Emilio Montravers, Philippe Mikstacki, Adam Paiva, Jose-Artur Pereyra, Cecilia Rello, Jordi Timsit, Jean-Francois Vogelaers, Dirk Lamrous, Amin Rezende-Neto, Joao Cardenas, Yenny Vymazal, Tomas Fjeldsoee-Nielsen, Hans Kott, Matthias Kostoula, Arvaniti Javeri, Yash Einav, Sharon Umezawa Makikado, Luis Daniel Tomescu, Dana Gritsan, Alexey Jovanovic, Bojan Venkatesan, Kumaresh Mirkovic, Tomislav Creagh-Brown, Benedict Emmerich, Monica Canale, Mariana Silvina Dietz, Lorena Ilutovich, Santiago Sanchez Minope, John Thomas Baldomera Silva, Ramona Alexis Montenegro, Martin Martin, Patricio Saul, Pablo Chediack, Viviana Sutton, Giselle Couce, Rocio Balasini, Carina Gonzalez, Susana Lascar, Florencia Maria Jorge Descotte, Emiliano Soledad Gumiela, Natalia Alejandra Pino, Carina Cesio, Cristian Valgolio, Emanuel Cunto, Eleonora Dominguez, Cecilia Funes Nelson, Nydia Martin Abegao, Esteban Christian Pozo, Norberto Bianchi, Luciana Correger, Enrique Laura Pastorino, Maria Aurora Miyazaki, Erica Grubissich, Nicolas Garcia, Mariel Bonetto, Natalia Elizabeth Quevedo, Noelia Delia Gomez, Cristina Queti, Felipe Gonzalez Estevarena, Luis Cruz, Godoy Fernandez, Ruben Santolaya, Ignacio Grangeat, Sergio Hugo Doglia, Juan Zakalik, Graciela Pellegrini, Carlos Monserrat Lloria, Maria Esteban Chacon, Mercedes Fumale, Mariela Leguizamon, Mariela Beatriz Hidalgo, Irene Julian Tiranti, Roberto Capponi, Paola Tita, Agustin Cardonnet, Luis Bettini, Lisandro Ramos, Agnel Lovesio, Luciano Miriam Miranda, Edith Beatriz Farfan, Angelica Tolosa, Carina Segura, Lise |
| description | 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. |
| format | Article |
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Antonelli, Massimo ; Arvaniti, Kostoula ; Blot, Koen ; Creagh-Brown, Ben ; de Lange, Dylan ; De Waele, Jan ; Deschepper, Mieke ; Dikmen, Yalim ; Dimopoulos, George ; Eckmann, Christian ; Francois, Guy ; Girardis, Massimo ; Koulenti, Despoina ; Labeau, Sonia ; Lipman, Jeffrey ; Lipovestky, Fernando ; Maseda, Emilio ; Montravers, Philippe ; Mikstacki, Adam ; Paiva, Jose-Artur ; Pereyra, Cecilia ; Rello, Jordi ; Timsit, Jean-Francois ; Vogelaers, Dirk ; Lamrous, Amin ; Rezende-Neto, Joao ; Cardenas, Yenny ; Vymazal, Tomas ; Fjeldsoee-Nielsen, Hans ; Kott, Matthias ; Kostoula, Arvaniti ; Javeri, Yash ; Einav, Sharon ; Umezawa Makikado, Luis Daniel ; Tomescu, Dana ; Gritsan, Alexey ; Jovanovic, Bojan ; Venkatesan, Kumaresh ; Mirkovic, Tomislav ; Creagh-Brown, Benedict ; Emmerich, Monica ; Canale, Mariana ; Silvina Dietz, Lorena ; Ilutovich, Santiago ; Sanchez Minope, John Thomas ; Baldomera Silva, Ramona ; Alexis Montenegro, Martin ; Martin, Patricio ; Saul, Pablo ; Chediack, Viviana ; Sutton, Giselle ; Couce, Rocio ; Balasini, Carina ; Gonzalez, Susana ; Lascar, Florencia Maria ; Jorge Descotte, Emiliano ; Soledad Gumiela, Natalia ; Alejandra Pino, Carina ; Cesio, Cristian ; Valgolio, Emanuel ; Cunto, Eleonora ; Dominguez, Cecilia ; Funes Nelson, Nydia ; Martin Abegao, Esteban ; Christian Pozo, Norberto ; Bianchi, Luciana ; Correger, Enrique ; Laura Pastorino, Maria ; Aurora Miyazaki, Erica ; Grubissich, Nicolas ; Garcia, Mariel ; Bonetto, Natalia ; Elizabeth Quevedo, Noelia ; Delia Gomez, Cristina ; Queti, Felipe ; Gonzalez Estevarena, Luis ; Cruz, Godoy ; Fernandez, Ruben ; Santolaya, Ignacio ; Grangeat, Sergio Hugo ; Doglia, Juan ; Zakalik, Graciela ; Pellegrini, Carlos ; Monserrat Lloria, Maria ; Esteban Chacon, Mercedes ; Fumale, Mariela ; Leguizamon, Mariela ; Beatriz Hidalgo, Irene ; Julian Tiranti, Roberto ; Capponi, Paola ; Tita, Agustin ; Cardonnet, Luis ; Bettini, Lisandro ; Ramos, Agnel ; Lovesio, Luciano ; Miriam Miranda, Edith ; Beatriz Farfan, Angelica ; Tolosa, Carina ; Segura, Lise</creator><creatorcontrib>Blot, Stijn ; Antonelli, Massimo ; Arvaniti, Kostoula ; Blot, Koen ; Creagh-Brown, Ben ; de Lange, Dylan ; De Waele, Jan ; Deschepper, Mieke ; Dikmen, Yalim ; Dimopoulos, George ; Eckmann, Christian ; Francois, Guy ; Girardis, Massimo ; Koulenti, Despoina ; Labeau, Sonia ; Lipman, Jeffrey ; Lipovestky, Fernando ; Maseda, Emilio ; Montravers, Philippe ; Mikstacki, Adam ; Paiva, Jose-Artur ; Pereyra, Cecilia ; Rello, Jordi ; Timsit, Jean-Francois ; Vogelaers, Dirk ; Lamrous, Amin ; Rezende-Neto, Joao ; Cardenas, Yenny ; Vymazal, Tomas ; Fjeldsoee-Nielsen, Hans ; Kott, Matthias ; Kostoula, Arvaniti ; Javeri, Yash ; Einav, Sharon ; Umezawa Makikado, Luis Daniel ; Tomescu, Dana ; Gritsan, Alexey ; Jovanovic, Bojan ; Venkatesan, Kumaresh ; Mirkovic, Tomislav ; Creagh-Brown, Benedict ; Emmerich, Monica ; Canale, Mariana ; Silvina Dietz, Lorena ; Ilutovich, Santiago ; Sanchez Minope, John Thomas ; Baldomera Silva, Ramona ; Alexis Montenegro, Martin ; Martin, Patricio ; Saul, Pablo ; Chediack, Viviana ; Sutton, Giselle ; Couce, Rocio ; Balasini, Carina ; Gonzalez, Susana ; Lascar, Florencia Maria ; Jorge Descotte, Emiliano ; Soledad Gumiela, Natalia ; Alejandra Pino, Carina ; Cesio, Cristian ; Valgolio, Emanuel ; Cunto, Eleonora ; Dominguez, Cecilia ; Funes Nelson, Nydia ; Martin Abegao, Esteban ; Christian Pozo, Norberto ; Bianchi, Luciana ; Correger, Enrique ; Laura Pastorino, Maria ; Aurora Miyazaki, Erica ; Grubissich, Nicolas ; Garcia, Mariel ; Bonetto, Natalia ; Elizabeth Quevedo, Noelia ; Delia Gomez, Cristina ; Queti, Felipe ; Gonzalez Estevarena, Luis ; Cruz, Godoy ; Fernandez, Ruben ; Santolaya, Ignacio ; Grangeat, Sergio Hugo ; Doglia, Juan ; Zakalik, Graciela ; Pellegrini, Carlos ; Monserrat Lloria, Maria ; Esteban Chacon, Mercedes ; Fumale, Mariela ; Leguizamon, Mariela ; Beatriz Hidalgo, Irene ; Julian Tiranti, Roberto ; Capponi, Paola ; Tita, Agustin ; Cardonnet, Luis ; Bettini, Lisandro ; Ramos, Agnel ; Lovesio, Luciano ; Miriam Miranda, Edith ; Beatriz Farfan, Angelica ; Tolosa, Carina ; Segura, Lise</creatorcontrib><description>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.</description><identifier>ISSN: 0342-4642</identifier><language>eng</language><publisher>SPRINGER</publisher><ispartof>INTENSIVE CARE MEDICINE, 2019-10, Vol.45 (12), p.1703-1717</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,316,781,785,27865</link.rule.ids></links><search><creatorcontrib>Blot, Stijn</creatorcontrib><creatorcontrib>Antonelli, Massimo</creatorcontrib><creatorcontrib>Arvaniti, Kostoula</creatorcontrib><creatorcontrib>Blot, Koen</creatorcontrib><creatorcontrib>Creagh-Brown, Ben</creatorcontrib><creatorcontrib>de Lange, Dylan</creatorcontrib><creatorcontrib>De Waele, Jan</creatorcontrib><creatorcontrib>Deschepper, Mieke</creatorcontrib><creatorcontrib>Dikmen, Yalim</creatorcontrib><creatorcontrib>Dimopoulos, George</creatorcontrib><creatorcontrib>Eckmann, Christian</creatorcontrib><creatorcontrib>Francois, Guy</creatorcontrib><creatorcontrib>Girardis, Massimo</creatorcontrib><creatorcontrib>Koulenti, Despoina</creatorcontrib><creatorcontrib>Labeau, Sonia</creatorcontrib><creatorcontrib>Lipman, Jeffrey</creatorcontrib><creatorcontrib>Lipovestky, Fernando</creatorcontrib><creatorcontrib>Maseda, Emilio</creatorcontrib><creatorcontrib>Montravers, Philippe</creatorcontrib><creatorcontrib>Mikstacki, Adam</creatorcontrib><creatorcontrib>Paiva, Jose-Artur</creatorcontrib><creatorcontrib>Pereyra, Cecilia</creatorcontrib><creatorcontrib>Rello, Jordi</creatorcontrib><creatorcontrib>Timsit, Jean-Francois</creatorcontrib><creatorcontrib>Vogelaers, Dirk</creatorcontrib><creatorcontrib>Lamrous, Amin</creatorcontrib><creatorcontrib>Rezende-Neto, Joao</creatorcontrib><creatorcontrib>Cardenas, Yenny</creatorcontrib><creatorcontrib>Vymazal, Tomas</creatorcontrib><creatorcontrib>Fjeldsoee-Nielsen, Hans</creatorcontrib><creatorcontrib>Kott, Matthias</creatorcontrib><creatorcontrib>Kostoula, Arvaniti</creatorcontrib><creatorcontrib>Javeri, Yash</creatorcontrib><creatorcontrib>Einav, Sharon</creatorcontrib><creatorcontrib>Umezawa Makikado, Luis Daniel</creatorcontrib><creatorcontrib>Tomescu, Dana</creatorcontrib><creatorcontrib>Gritsan, Alexey</creatorcontrib><creatorcontrib>Jovanovic, Bojan</creatorcontrib><creatorcontrib>Venkatesan, Kumaresh</creatorcontrib><creatorcontrib>Mirkovic, Tomislav</creatorcontrib><creatorcontrib>Creagh-Brown, Benedict</creatorcontrib><creatorcontrib>Emmerich, Monica</creatorcontrib><creatorcontrib>Canale, Mariana</creatorcontrib><creatorcontrib>Silvina Dietz, Lorena</creatorcontrib><creatorcontrib>Ilutovich, Santiago</creatorcontrib><creatorcontrib>Sanchez Minope, John Thomas</creatorcontrib><creatorcontrib>Baldomera Silva, Ramona</creatorcontrib><creatorcontrib>Alexis Montenegro, Martin</creatorcontrib><creatorcontrib>Martin, Patricio</creatorcontrib><creatorcontrib>Saul, Pablo</creatorcontrib><creatorcontrib>Chediack, Viviana</creatorcontrib><creatorcontrib>Sutton, Giselle</creatorcontrib><creatorcontrib>Couce, Rocio</creatorcontrib><creatorcontrib>Balasini, Carina</creatorcontrib><creatorcontrib>Gonzalez, Susana</creatorcontrib><creatorcontrib>Lascar, Florencia Maria</creatorcontrib><creatorcontrib>Jorge Descotte, Emiliano</creatorcontrib><creatorcontrib>Soledad Gumiela, Natalia</creatorcontrib><creatorcontrib>Alejandra Pino, Carina</creatorcontrib><creatorcontrib>Cesio, Cristian</creatorcontrib><creatorcontrib>Valgolio, Emanuel</creatorcontrib><creatorcontrib>Cunto, Eleonora</creatorcontrib><creatorcontrib>Dominguez, Cecilia</creatorcontrib><creatorcontrib>Funes Nelson, Nydia</creatorcontrib><creatorcontrib>Martin Abegao, Esteban</creatorcontrib><creatorcontrib>Christian Pozo, Norberto</creatorcontrib><creatorcontrib>Bianchi, Luciana</creatorcontrib><creatorcontrib>Correger, Enrique</creatorcontrib><creatorcontrib>Laura Pastorino, Maria</creatorcontrib><creatorcontrib>Aurora Miyazaki, Erica</creatorcontrib><creatorcontrib>Grubissich, Nicolas</creatorcontrib><creatorcontrib>Garcia, Mariel</creatorcontrib><creatorcontrib>Bonetto, Natalia</creatorcontrib><creatorcontrib>Elizabeth Quevedo, Noelia</creatorcontrib><creatorcontrib>Delia Gomez, Cristina</creatorcontrib><creatorcontrib>Queti, Felipe</creatorcontrib><creatorcontrib>Gonzalez Estevarena, Luis</creatorcontrib><creatorcontrib>Cruz, Godoy</creatorcontrib><creatorcontrib>Fernandez, Ruben</creatorcontrib><creatorcontrib>Santolaya, Ignacio</creatorcontrib><creatorcontrib>Grangeat, Sergio Hugo</creatorcontrib><creatorcontrib>Doglia, Juan</creatorcontrib><creatorcontrib>Zakalik, Graciela</creatorcontrib><creatorcontrib>Pellegrini, Carlos</creatorcontrib><creatorcontrib>Monserrat Lloria, Maria</creatorcontrib><creatorcontrib>Esteban Chacon, Mercedes</creatorcontrib><creatorcontrib>Fumale, Mariela</creatorcontrib><creatorcontrib>Leguizamon, Mariela</creatorcontrib><creatorcontrib>Beatriz Hidalgo, Irene</creatorcontrib><creatorcontrib>Julian Tiranti, Roberto</creatorcontrib><creatorcontrib>Capponi, Paola</creatorcontrib><creatorcontrib>Tita, Agustin</creatorcontrib><creatorcontrib>Cardonnet, Luis</creatorcontrib><creatorcontrib>Bettini, Lisandro</creatorcontrib><creatorcontrib>Ramos, Agnel</creatorcontrib><creatorcontrib>Lovesio, Luciano</creatorcontrib><creatorcontrib>Miriam Miranda, Edith</creatorcontrib><creatorcontrib>Beatriz Farfan, Angelica</creatorcontrib><creatorcontrib>Tolosa, Carina</creatorcontrib><creatorcontrib>Segura, Lise</creatorcontrib><title>Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project</title><title>INTENSIVE CARE MEDICINE</title><description>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.</description><issn>0342-4642</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>FZOIL</sourceid><recordid>eNqNjctOwzAURL0AqaX0H666YQGR8m5gh6rwWCAhpfvIsR24xbEtPyryPfwoBsG-q9GMZs6ckWValHlS1mW-IBfOHdI029ZVtiRfrUEuJtRSv82gR0DlLU3owPWEisroR8E8agVUcXDCOHQxBGbRI6NSzoBSgqEehfLuDjb3Qye6zQ1QmIL0EfKzjiQ9OGGP_47pd209OB_4_Ituu-fdC-wtUung0epg4NXqQzy_JOdjDMX6T1fk6qHd756SjyBFOArVc2coE32WF2VVb5vbvq7SrGmKFbk-rdn7T1-czv0GKAlrTg</recordid><startdate>20191029</startdate><enddate>20191029</enddate><creator>Blot, Stijn</creator><creator>Antonelli, Massimo</creator><creator>Arvaniti, Kostoula</creator><creator>Blot, Koen</creator><creator>Creagh-Brown, Ben</creator><creator>de Lange, Dylan</creator><creator>De Waele, Jan</creator><creator>Deschepper, Mieke</creator><creator>Dikmen, Yalim</creator><creator>Dimopoulos, 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Roberto</creator><creator>Capponi, Paola</creator><creator>Tita, Agustin</creator><creator>Cardonnet, Luis</creator><creator>Bettini, Lisandro</creator><creator>Ramos, Agnel</creator><creator>Lovesio, Luciano</creator><creator>Miriam Miranda, Edith</creator><creator>Beatriz Farfan, Angelica</creator><creator>Tolosa, Carina</creator><creator>Segura, Lise</creator><general>SPRINGER</general><scope>FZOIL</scope></search><sort><creationdate>20191029</creationdate><title>Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project</title><author>Blot, Stijn ; Antonelli, Massimo ; Arvaniti, Kostoula ; Blot, Koen ; Creagh-Brown, Ben ; de Lange, Dylan ; De Waele, Jan ; Deschepper, Mieke ; Dikmen, Yalim ; Dimopoulos, George ; Eckmann, Christian ; Francois, Guy ; Girardis, Massimo ; Koulenti, Despoina ; Labeau, Sonia ; Lipman, Jeffrey ; Lipovestky, Fernando ; Maseda, Emilio ; Montravers, Philippe ; Mikstacki, Adam ; Paiva, Jose-Artur ; Pereyra, Cecilia ; Rello, Jordi ; Timsit, Jean-Francois ; Vogelaers, Dirk ; Lamrous, Amin ; Rezende-Neto, Joao ; Cardenas, Yenny ; Vymazal, Tomas ; Fjeldsoee-Nielsen, Hans ; Kott, Matthias ; Kostoula, Arvaniti ; Javeri, Yash ; Einav, Sharon ; Umezawa Makikado, Luis Daniel ; Tomescu, Dana ; Gritsan, Alexey ; Jovanovic, Bojan ; Venkatesan, Kumaresh ; Mirkovic, Tomislav ; Creagh-Brown, Benedict ; Emmerich, Monica ; Canale, Mariana ; Silvina Dietz, Lorena ; Ilutovich, Santiago ; Sanchez Minope, John Thomas ; Baldomera Silva, Ramona ; Alexis Montenegro, Martin ; Martin, Patricio ; Saul, Pablo ; Chediack, Viviana ; Sutton, Giselle ; Couce, Rocio ; Balasini, Carina ; Gonzalez, Susana ; Lascar, Florencia Maria ; Jorge Descotte, Emiliano ; Soledad Gumiela, Natalia ; Alejandra Pino, Carina ; Cesio, Cristian ; Valgolio, Emanuel ; Cunto, Eleonora ; Dominguez, Cecilia ; Funes Nelson, Nydia ; Martin Abegao, Esteban ; Christian Pozo, Norberto ; Bianchi, Luciana ; Correger, Enrique ; Laura Pastorino, Maria ; Aurora Miyazaki, Erica ; Grubissich, Nicolas ; Garcia, Mariel ; Bonetto, Natalia ; Elizabeth Quevedo, Noelia ; Delia Gomez, Cristina ; Queti, Felipe ; Gonzalez Estevarena, Luis ; Cruz, Godoy ; Fernandez, Ruben ; Santolaya, Ignacio ; Grangeat, Sergio Hugo ; Doglia, Juan ; Zakalik, Graciela ; Pellegrini, Carlos ; Monserrat Lloria, Maria ; Esteban Chacon, Mercedes ; Fumale, Mariela ; Leguizamon, Mariela ; Beatriz Hidalgo, Irene ; Julian Tiranti, Roberto ; Capponi, Paola ; Tita, Agustin ; Cardonnet, Luis ; Bettini, Lisandro ; Ramos, Agnel ; Lovesio, Luciano ; Miriam Miranda, Edith ; Beatriz Farfan, Angelica ; Tolosa, Carina ; Segura, Lise</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-kuleuven_dspace_123456789_6501883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Blot, Stijn</creatorcontrib><creatorcontrib>Antonelli, Massimo</creatorcontrib><creatorcontrib>Arvaniti, Kostoula</creatorcontrib><creatorcontrib>Blot, Koen</creatorcontrib><creatorcontrib>Creagh-Brown, Ben</creatorcontrib><creatorcontrib>de Lange, Dylan</creatorcontrib><creatorcontrib>De Waele, Jan</creatorcontrib><creatorcontrib>Deschepper, Mieke</creatorcontrib><creatorcontrib>Dikmen, Yalim</creatorcontrib><creatorcontrib>Dimopoulos, George</creatorcontrib><creatorcontrib>Eckmann, Christian</creatorcontrib><creatorcontrib>Francois, Guy</creatorcontrib><creatorcontrib>Girardis, Massimo</creatorcontrib><creatorcontrib>Koulenti, Despoina</creatorcontrib><creatorcontrib>Labeau, Sonia</creatorcontrib><creatorcontrib>Lipman, Jeffrey</creatorcontrib><creatorcontrib>Lipovestky, Fernando</creatorcontrib><creatorcontrib>Maseda, Emilio</creatorcontrib><creatorcontrib>Montravers, Philippe</creatorcontrib><creatorcontrib>Mikstacki, Adam</creatorcontrib><creatorcontrib>Paiva, Jose-Artur</creatorcontrib><creatorcontrib>Pereyra, Cecilia</creatorcontrib><creatorcontrib>Rello, Jordi</creatorcontrib><creatorcontrib>Timsit, Jean-Francois</creatorcontrib><creatorcontrib>Vogelaers, Dirk</creatorcontrib><creatorcontrib>Lamrous, Amin</creatorcontrib><creatorcontrib>Rezende-Neto, Joao</creatorcontrib><creatorcontrib>Cardenas, Yenny</creatorcontrib><creatorcontrib>Vymazal, Tomas</creatorcontrib><creatorcontrib>Fjeldsoee-Nielsen, Hans</creatorcontrib><creatorcontrib>Kott, Matthias</creatorcontrib><creatorcontrib>Kostoula, Arvaniti</creatorcontrib><creatorcontrib>Javeri, Yash</creatorcontrib><creatorcontrib>Einav, Sharon</creatorcontrib><creatorcontrib>Umezawa Makikado, Luis Daniel</creatorcontrib><creatorcontrib>Tomescu, Dana</creatorcontrib><creatorcontrib>Gritsan, Alexey</creatorcontrib><creatorcontrib>Jovanovic, Bojan</creatorcontrib><creatorcontrib>Venkatesan, Kumaresh</creatorcontrib><creatorcontrib>Mirkovic, Tomislav</creatorcontrib><creatorcontrib>Creagh-Brown, Benedict</creatorcontrib><creatorcontrib>Emmerich, Monica</creatorcontrib><creatorcontrib>Canale, Mariana</creatorcontrib><creatorcontrib>Silvina Dietz, Lorena</creatorcontrib><creatorcontrib>Ilutovich, Santiago</creatorcontrib><creatorcontrib>Sanchez Minope, John Thomas</creatorcontrib><creatorcontrib>Baldomera Silva, Ramona</creatorcontrib><creatorcontrib>Alexis Montenegro, Martin</creatorcontrib><creatorcontrib>Martin, Patricio</creatorcontrib><creatorcontrib>Saul, Pablo</creatorcontrib><creatorcontrib>Chediack, Viviana</creatorcontrib><creatorcontrib>Sutton, Giselle</creatorcontrib><creatorcontrib>Couce, Rocio</creatorcontrib><creatorcontrib>Balasini, Carina</creatorcontrib><creatorcontrib>Gonzalez, Susana</creatorcontrib><creatorcontrib>Lascar, Florencia Maria</creatorcontrib><creatorcontrib>Jorge Descotte, Emiliano</creatorcontrib><creatorcontrib>Soledad Gumiela, Natalia</creatorcontrib><creatorcontrib>Alejandra Pino, Carina</creatorcontrib><creatorcontrib>Cesio, Cristian</creatorcontrib><creatorcontrib>Valgolio, Emanuel</creatorcontrib><creatorcontrib>Cunto, Eleonora</creatorcontrib><creatorcontrib>Dominguez, Cecilia</creatorcontrib><creatorcontrib>Funes Nelson, Nydia</creatorcontrib><creatorcontrib>Martin Abegao, Esteban</creatorcontrib><creatorcontrib>Christian Pozo, Norberto</creatorcontrib><creatorcontrib>Bianchi, Luciana</creatorcontrib><creatorcontrib>Correger, Enrique</creatorcontrib><creatorcontrib>Laura Pastorino, Maria</creatorcontrib><creatorcontrib>Aurora Miyazaki, Erica</creatorcontrib><creatorcontrib>Grubissich, Nicolas</creatorcontrib><creatorcontrib>Garcia, Mariel</creatorcontrib><creatorcontrib>Bonetto, Natalia</creatorcontrib><creatorcontrib>Elizabeth Quevedo, Noelia</creatorcontrib><creatorcontrib>Delia Gomez, Cristina</creatorcontrib><creatorcontrib>Queti, Felipe</creatorcontrib><creatorcontrib>Gonzalez Estevarena, Luis</creatorcontrib><creatorcontrib>Cruz, Godoy</creatorcontrib><creatorcontrib>Fernandez, Ruben</creatorcontrib><creatorcontrib>Santolaya, Ignacio</creatorcontrib><creatorcontrib>Grangeat, Sergio Hugo</creatorcontrib><creatorcontrib>Doglia, Juan</creatorcontrib><creatorcontrib>Zakalik, Graciela</creatorcontrib><creatorcontrib>Pellegrini, Carlos</creatorcontrib><creatorcontrib>Monserrat Lloria, Maria</creatorcontrib><creatorcontrib>Esteban Chacon, Mercedes</creatorcontrib><creatorcontrib>Fumale, Mariela</creatorcontrib><creatorcontrib>Leguizamon, Mariela</creatorcontrib><creatorcontrib>Beatriz Hidalgo, Irene</creatorcontrib><creatorcontrib>Julian Tiranti, Roberto</creatorcontrib><creatorcontrib>Capponi, Paola</creatorcontrib><creatorcontrib>Tita, Agustin</creatorcontrib><creatorcontrib>Cardonnet, Luis</creatorcontrib><creatorcontrib>Bettini, Lisandro</creatorcontrib><creatorcontrib>Ramos, Agnel</creatorcontrib><creatorcontrib>Lovesio, Luciano</creatorcontrib><creatorcontrib>Miriam Miranda, Edith</creatorcontrib><creatorcontrib>Beatriz Farfan, Angelica</creatorcontrib><creatorcontrib>Tolosa, Carina</creatorcontrib><creatorcontrib>Segura, Lise</creatorcontrib><collection>Lirias (KU Leuven Association)</collection><jtitle>INTENSIVE CARE MEDICINE</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blot, Stijn</au><au>Antonelli, Massimo</au><au>Arvaniti, Kostoula</au><au>Blot, Koen</au><au>Creagh-Brown, Ben</au><au>de Lange, Dylan</au><au>De Waele, Jan</au><au>Deschepper, Mieke</au><au>Dikmen, Yalim</au><au>Dimopoulos, George</au><au>Eckmann, Christian</au><au>Francois, Guy</au><au>Girardis, Massimo</au><au>Koulenti, Despoina</au><au>Labeau, Sonia</au><au>Lipman, Jeffrey</au><au>Lipovestky, Fernando</au><au>Maseda, Emilio</au><au>Montravers, Philippe</au><au>Mikstacki, Adam</au><au>Paiva, Jose-Artur</au><au>Pereyra, Cecilia</au><au>Rello, Jordi</au><au>Timsit, Jean-Francois</au><au>Vogelaers, Dirk</au><au>Lamrous, Amin</au><au>Rezende-Neto, Joao</au><au>Cardenas, Yenny</au><au>Vymazal, Tomas</au><au>Fjeldsoee-Nielsen, Hans</au><au>Kott, Matthias</au><au>Kostoula, Arvaniti</au><au>Javeri, Yash</au><au>Einav, Sharon</au><au>Umezawa Makikado, Luis Daniel</au><au>Tomescu, Dana</au><au>Gritsan, Alexey</au><au>Jovanovic, Bojan</au><au>Venkatesan, Kumaresh</au><au>Mirkovic, Tomislav</au><au>Creagh-Brown, Benedict</au><au>Emmerich, Monica</au><au>Canale, Mariana</au><au>Silvina Dietz, Lorena</au><au>Ilutovich, Santiago</au><au>Sanchez Minope, John Thomas</au><au>Baldomera Silva, Ramona</au><au>Alexis Montenegro, Martin</au><au>Martin, Patricio</au><au>Saul, Pablo</au><au>Chediack, Viviana</au><au>Sutton, Giselle</au><au>Couce, Rocio</au><au>Balasini, Carina</au><au>Gonzalez, Susana</au><au>Lascar, Florencia Maria</au><au>Jorge Descotte, Emiliano</au><au>Soledad Gumiela, Natalia</au><au>Alejandra Pino, Carina</au><au>Cesio, Cristian</au><au>Valgolio, Emanuel</au><au>Cunto, Eleonora</au><au>Dominguez, Cecilia</au><au>Funes Nelson, Nydia</au><au>Martin Abegao, Esteban</au><au>Christian Pozo, Norberto</au><au>Bianchi, Luciana</au><au>Correger, Enrique</au><au>Laura Pastorino, Maria</au><au>Aurora Miyazaki, Erica</au><au>Grubissich, Nicolas</au><au>Garcia, Mariel</au><au>Bonetto, Natalia</au><au>Elizabeth Quevedo, Noelia</au><au>Delia Gomez, Cristina</au><au>Queti, Felipe</au><au>Gonzalez Estevarena, Luis</au><au>Cruz, Godoy</au><au>Fernandez, Ruben</au><au>Santolaya, Ignacio</au><au>Grangeat, Sergio Hugo</au><au>Doglia, Juan</au><au>Zakalik, Graciela</au><au>Pellegrini, Carlos</au><au>Monserrat Lloria, Maria</au><au>Esteban Chacon, Mercedes</au><au>Fumale, Mariela</au><au>Leguizamon, Mariela</au><au>Beatriz Hidalgo, Irene</au><au>Julian Tiranti, Roberto</au><au>Capponi, Paola</au><au>Tita, Agustin</au><au>Cardonnet, Luis</au><au>Bettini, Lisandro</au><au>Ramos, Agnel</au><au>Lovesio, Luciano</au><au>Miriam Miranda, Edith</au><au>Beatriz Farfan, Angelica</au><au>Tolosa, Carina</au><au>Segura, Lise</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project</atitle><jtitle>INTENSIVE CARE MEDICINE</jtitle><date>2019-10-29</date><risdate>2019</risdate><volume>45</volume><issue>12</issue><spage>1703</spage><epage>1717</epage><pages>1703-1717</pages><issn>0342-4642</issn><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.</abstract><pub>SPRINGER</pub><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0342-4642 |
| ispartof | INTENSIVE CARE MEDICINE, 2019-10, Vol.45 (12), p.1703-1717 |
| issn | 0342-4642 |
| language | eng |
| recordid | cdi_kuleuven_dspace_123456789_650188 |
| source | Lirias (KU Leuven Association); SpringerNature Journals |
| title | 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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