Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project
- Autori: 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.; Ilutovich S.; Minope J.T.S.; Silva R.B.; Montenegro M.A.; Martin P.; Saul P.; Chediack V.; Sutton G.; Couce R.; Balasini C.; Gonzalez S.; Lascar F.M.; Descotte E.J.; Gumiela N.S.; Pino C.A.; Cesio C.; Valgolio E.; Cunto E.; Dominguez C.; Nelson N.F.; Abegao E.M.; Pozo N.C.; Bianchi L.; Correger E.; Pastorino M.L.; Miyazaki E.A.; Pozo N.C.; Grubissich N.; Garcia M.; Bonetto N.; Quevedo N.E.; Gomez C.D.; Queti F.; Estevarena L.G.; Fernandez R.; Santolaya I.; Pozo N.C.; Grangeat S.H.; Doglia J.; Zakalik G.; Pellegrini C.; Lloria M.M.; Chacon M.E.; Fumale M.; Leguizamon M.; Hidalgo I.B.; Tiranti R.J.; Capponi P.; Tita A.; Cardonnet L.; Bettini L.; Ramos A.; Lovesio L.; Miranda E.M.; Farfan A.B.; Tolosa C.; Segura L.; Bellocchio A.; Alvarez B.; Manzur A.; Lujan R.; Fernandez N.; Scarone N.; Zazu A.; Groh C.; Fletcher J.; Smith J.; Azad R.; Chavan N.; Wong H.; Kol M.; Campbell L.; Starr T.; Roberts B.; Wibrow B.; Warhurst T.; Chinthamuneedi M.; Ferney B.B.; Simon M.; De Backer D.; Wittebole X.; De Bels D.; Collin V.; Dams K.; Jorens P.; Dubois J.; Gunst J.; Haentjens L.; De Schryver N.; Dugernier T.; Rezende-Neto J.; Rizoli S.; Santillan P.; Han Y.; Biskup E.; Qu C.; Li X.; Yu T.; Weihua L.; Molano-Franco D.; Rojas J.; Oviedo J.M.P.; Pinilla D.; Cardenas Y.; Celis E.; Arias M.; Vukovic A.; Vudrag M.; Belavic M.; Zunic J.; Kuharic J.; Kricka I.B.; Filipovic-Grcic I.; Tomasevic B.; Obraz M.; Bodulica B.; Dohnal M.; Malaska J.; Kratochvil M.; Satinsky I.; Schwarz P.; Kos Z.; Blahut L.; Maca J.; Protus M.; Kieslichova E.; Nielsen L.G.; Krogh B.M.; Rivadeneira F.; Morales F.; Mora J.; Orozco A.S.; MorochoTutillo D.R.; Vargas N.R.; Yepez E.S.; Villamagua B.; Alsisi A.; Fahmy A.; Dupont H.; Lasocki S.; Paugam-Burtz C.; Foucrier A.; Nica A.; Barjon G.; Mallat J.; Marcotte G.; Leone M.; Duclos G.; Burtin P.; Atchade E.; Mahjoub Y.; Misset B.; Timsit J.-F.; Dupuis C.; Veber B.; Debarre M.; Collange O.; Pottecher J.; Hecketsweiler S.; Fromentin M.; Tesniere A.; Koch C.; Sander M.; Kott M.; Elke G.; Wrigge H.; Simon P.; Chalkiadaki A.; Tzanidakis C.; Pneumatikos I.; Sertaridou E.; Mastora Z.; Pantazopoulos I.; Papanikolaou M.; Papavasilopoulou T.; Floros J.; Kolonia V.; Diakaki C.; Rallis M.; Paridou A.; Kalogeromitros A.; Romanou V.; Nikolaou C.; Kounougeri K.; Tsigou E.; Psallida V.; Karampela N.; Mandragos K.; Kontoudaki E.; Pentheroudaki A.; Farazi-Chongouki C.; Karakosta A.; Chouris I.; Radu V.; Malliotakis P.; Kokkini S.; Charalambous E.; Kyritsi A.; Koulouras V.; Papathanakos G.; Nagky E.; Lampiri C.; Tsimpoukas F.; Sarakatsanos I.; Georgakopoulos P.; Ravani I.; Prekates A.; Sakellaridis K.; Christopoulos C.; Vrettou E.; Stokkos K.; Pentari A.; Marmanidou K.; Kydona C.; Tsoumaropoulos G.; Bitzani M.; Kontou P.; Voudouris A.; Elli-Nikki; Flioni; Antypa E.; Chasou E.; Anisoglou S.; Papageorgiou E.; Paraforou T.; Tsioka A.; Karathanou A.; Vakalos A.; Shah B.; Thakkar C.; Jain N.; Gurjar M.; Baronia A.; Sathe P.; Kulkarni S.; Paul C.; Paul J.; Masjedi M.; Nikandish R.; Zand F.; Sabetian G.; Mahmoodpoor A.; Hashemian S.M.; Bala M.; Flocco R.; Torrente S.; Pota V.; Spadaro S.; Volta C.; Serafini G.; Boraso S.; Tiberio I.; Cortegiani A.; Misseri G.; Barbagallo M.; Nicolotti D.; Forfori F.; Corradi F.; De Pascale G.; Pelagalli L.; Brazzi L.; Vittone F.G.; Russo A.; Simion D.; Cotoia A.; Cinnella G.; Toppin P.; Johnson-Jackson R.; Hayashi Y.; Yamamoto R.; Yasuda H.; Kish
- Anno di pubblicazione: 2019
- Tipologia: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/388103
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.