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BMC Infect Dis. 2014 Jul 29;14:420. doi: 10.1186/1471-2334-14-420.

Abdominal infections in the intensive care unit: characteristics, treatment and determinants of outcome.

Collaborators (1234)

Margarit A, Valentini R, Zazu AJ, Bevilacqua C, Curone M, Rabuffetti R, Comignani P, Torres Boden M, Chertcoff F, Adén F, Marcos L, Dónofrio M, Fernández R, Lamberghini R, Balasini S, Teves J, Las Heras M, Sinner J, Ceraso D, Curcio D, Aguilar L, Weller C, Cardonnet L, Santa Cruz R, Manrique E, Bernardez D, Iolster T, Chiappero G, Curcio D, Ramos P, Vergara J, Moine I, Ilutovich S, Jannello G, Waschbusch M, Rios Picaza G, Raimondi A, Miriam M, Parque S, Carlos L, Curcio D, Caridi M, Leong T, Orford N, Reece G, Ernest D, Hawker F, Tan J, Giannellis C, Ihle B, Bersten A, McInnes J, Tallott M, Mcfadyen B, Vibert J, Parr M, Tran K, Sutton J, Webb S, Groves N, Cole L, Long D, Bass F, Erickson S, Lipman J, Long D, Delzoppo C, Thomas J, Dobb G, Daley M, Roberts B, Webb S, Santamaria J, Young J, Festa M, Holland R, Mullany D, Williams P, Corkeron M, Gales M, Banerjee A, Yung M, Mutz N, Hiesmayr M, Faybik P, Fitzgerald R, Firlinger F, Zasmeta G, Zink M, Sieber W, Hildegard J, Bakondy R, Schlieber J, Filzwieser G, Beer R, Joannidis M, Staudinger T, Schuster R, Scherzer W, Smolle K, Fitzal S, Manzoor R, Brunain J, Dive A, Huylenbroeck G, Van der Schueren M, H 't Kindt, Slock E, Rijckaert D, Raemaekers J, Bourgeois M, Gusu D, Van Cotthem I, Nackaerts G, Gadisseaux P, Olivier V, Lignian H, Michel P, Fraipont V, Van der Stappen M, Forêt F, De Bels D, Devriendt J, Massaut J, Biston P, Roman A, Lambermont B, De Meulder A, Frederic V, Sottiaux T, Ruyffelaere P, Collin V, Anane S, Kleiren P, Simon M, Machayekhi S, Frans E, Leroy G, Berghmans T, Joseph R, Eerens J, Laterre PF, Lagrou B, Rutsaert R, Pisarek W, Dive A, De Waele J, Spapen H, Damas P, Vincent JL, Malbrain M, Hidalgo J, Baptista M, Salgado D, Braga M, Avila C, Westphal G, Caser E, Alves A, Friedman G, Luz M, Assuncao M, Reis H, Gomes A, Silva U, Nogueira WF, El-Dash S, Valiatti J, Cavalcanti A, Barbosa A, Coelho C, Knibel M, Minelli C, Caovilla J, Teixeira G, Hovnanian A, Rea-Neto A, Lobo SL, Lugarinho M, Souza P, Ferreira D, Duarte P, Oliveira M, Marques J, Machado R, Rehder P, Mataloun S, Grilo M, Quesado P, Moock M, Ferreira F, Teles J, Silva E, Coelho C, Morais A, Carvalho F, Wanderley M, Velasco M, Brandão da Silva N, Feijó J, Duarte P, Dantas VS, Teles J, Costa Filho R, Japiassu A, Villela D, Santos C, Passos R, Alheira-Rocha R, Silva R, Houly J, Aldrighi J, Hatum R, Suparregui Dias F, Ferreira L, Ferro L, Gomez J, Fleury R, David C, Resener T, Duarte P, Mendes C, Germano A, Oliveira M, De Marco F, Japiassu A, Lage S, Salluh J, Torelly A, Sad R, Barbosa A, Oliveira G, Lima R, Paranhos J, Oliveira M, Rocha M, Bitencourt W, Rea-Neto A, Grion C, Forte D, Guimarães H, Piras C, Stephanova L, Lyubenov L, Tsarianski G, Dimov G, Green R, Levasseur J, Ward R, Lesur O, Poirier G, Wax R, Wood G, Cook D, Marshall J, Herridge M, Ferguson N, Wood G, Espinoza M, Valdés Jimenez S, Bruhn A, Micolich J, Galvez S, Escamilla Leon I, Zhan Q, Xu Y, Zhao Y, Zhang L, Qin T, Du B, Li M, Wang X, Jing Y, Zhang Z, Xianyao W, Li F, Congshan Y, Rebolledo C, Diaz D, Murillo Arboleda R, Rebolledo C, Arias Antun A, Montenegro G, Granados M, Duenas C, Perez N, Libreros Duque G, Coral M, Ortiz G, Rodriguez D, Barsic B, Cubrilo-Turek M, Gornik I, Grljusic M, Caballero Lopez A, Iraola Ferrer M, Pavlik P, Manak J, Radej J, Belohlavek J, Sevcik P, Blahut L, Tyl D, Steinbach J, Herold I, Zykova I, Prchal D, Bartosik T, Kolarova M, Hájek R, Kohoutová J, Marek O, Hon P, Chytra I, Betsch H, Fogh B, Espersen K, Jacobsen K, Berezowicz P, Guerrero F, Salgado E, Barahona D, Del Pozo Sanchez H, Jibaja M, Alansary A, Reintam A, Starkopf J, Harjola V, Tual L, Leone M, Serge M, Michel P, Leroy O, Mallet L, Marc B, Dormoy D, Pascal H, Tronchon L, Garrigues B, Santré C, Dupont H, Duranteau J, Leon A, Henry L, Canevet C, Dube L, Julien H, Nadia A, Francois B, Gérard J, Freysz M, Remy G, Blanloeil Y, Squara P, Korach J, Durand M, Gabriel C, Eric P, Jacobs F, Bronchard R, Kipnis E, Moussa M, Launoy A, Guérin C, Vanhems P, Wynckel A, Clair B, Azoulay E, Fulgencio J, Gottwalles Y, Krummel T, Lepape A, Lesieur O, Payen D, Hérvé O, Farkas J, Cougot P, Malledant Y, Joannes-Boyau O, Standl T, Sierig U, Geiseler J, Hopf H, Burgau M, Conrad-Opel E, Hermann C, Ventzke M, Henneberg T, Loeser H, Spies C, Spies C, Esposito F, Zuckermann-Becker H, Scherer R, Pauer A, Kljucar S, Delfs K, Blank E, Busch J, Wendt K, Leßmann J, Busch J, Bach F, Sakr Y, Stolt C, Berlet T, Kernchen A, Quintel M, Holst D, Kilger E, Holubarsch T, Raufhake C, Kuhlen R, Lubasch A, Meier-Hellmann A, Woebker G, Scharnofske C, Breyer M, Risch T, Manhold C, Kljucar S, Goethe JW, Meininger D, Greive C, Rau J, Seibel A, Henn-Beilharz A, Wolbert R, Scherke T, Martin J, Rudolph M, Gleißner J, Wolf M, Schleibach F, Jaschinski U, Lunkeit A, Welte M, Bingold T, Sydow K, Kogelmann K, Fischer F, Fischer B, Schmid M, Klein M, Bechtold A, Bodmann K, Klasen J, Meyrl H, Goetz J, Geldner G, Helmes T, Jensen N, Eickmeyer H, Lengfelder W, Langenstein B, Bogdanski R, Jelen-Esselborn S, Umgelter A, Dörr F, Lüttje K, Heinemeyer D, Uhl M, Schirle P, Benad H, Glaser M, Panzer W, Huettemann E, Stierwaldt R, Schappacher M, Müller E, Stadlmeyer W, Fantini M, Dummer B, Thörner M, Jost V, Loerbroks T, Glück T, Zimmermann R, Clement R, Hering R, Klinger T, Mehl J, Polozek H, Rothhammer A, Seidler R, Lorenz P, Lutze M, Euler M, Heintz M, Winkler M, Angstwurm M, Krohe K, Treu T, Steiner T, Locher S, Walz A, Zahn P, Brandt W, Marks M, Henning F, Janssens U, Luethgens M, Theelen W, Sydow M, Weber M, Meiser A, Deutschmann C, Buttner C, Jokiel M, Bozzetti C, Jürgen B, Fiedler F, Wresch K, Kremer A, Bleier H, Rueckert M, Ditter H, Peckelsen C, Friederich P, Weber K, Krueger W, Lowack R, Michalsen A, Ragaller M, Groeschel A, Friedrich T, Hoffmann U, Hinz M, Christel A, Ragaller M, Hartwig T, Vögeler S, Weiss M, Reiter K, Schwab T, Trieschmann U, Kindgen-Milles D, Engel J, Sedemund-Adib B, Lauterbach M, Max M, Volkert T, Waydhas C, Hien S, Briegel J, Guralnik V, Zoremba N, Riessen R, Müllges W, Nierhaus A, Strauss R, Utzolino S, Thul J, Abel P, Gründling M, Keßler W, Scheuren K, Lothar E, Kaisers U, Schmitt D, Schneider D, Vagts D, Rensing H, Schoch B, Kopp K, Gerlach H, Corea M, Uhrig A, Schroeder S, Jordan F, Huber T, Bittinger M, Sofianos E, Armaganidis A, Routsi C, Bitzani M, Chalkiadaki A, Michalopoulos A, Mouloudi E, Ioannidou E, Myrianthefs P, Koulenti D, Karampela I, Kyriazopoulos G, Mandragos K, Clouva-Molyvdas P, Moraiti A, Pneumatikos I, Filos K, Zakynthinos E, Kotanidou A, Vakalos A, Cheng A, Buckley T, Gomersall C, Kiss K, Tamási P, Sarkany A, Csomos A, Zöllei É, Todi S, Udwadia F, Shah R, Amin P, Udwadia F, Samavedam S, Mathai A, Patil M, Jog S, Gurjar M, Vats M, Varma A, Gopal P, Kapadia F, Chawla R, Iyer S, Sahu S, Bakshi C, Ambike D, Govil D, Karipparambath V, Chacko J, Sathe P, Rungta N, Jani C, Bhome A, Prayag S, Ray S, Rajagopalan R, Divatia J, Da Costa R, Sunder TS, Wibowo P, Maskoen T, Sugiman T, Nowruzinia S, Lotfi A, Mahmoodpoor A, Donnelly M, Breen D, Ng S, Bates J, Sprung C, Lev A, Kishinevsky E, Cohen J, Sofer S, Vesconi S, Greco S, Borelli M, Cecilia P, Sapuppo M, Lazzero A, Mangani V, Petrucci N, Minerva M, De Blasio E, Marzorati S, Rosi R, Giarratano A, Margarit O, Guberti A, Scolz S, Stelian E, Emmi V, Caspani M, Rosano A, Abbruzzese C, Colonna S, Ceriani R, De Blasi R, Panella L, Borrelli F, Lorella P, Ruatti H, Munch C, Sorbara C, Fiore G, Chieregato A, Conti V, Guadagnucci A, Pizzamiglio M, Locicero M, Marri I, Sicignano A, Conte V, Oggioni R, De Gasperi A, De Negri P, Santagostino G, Fumagalli R, Marino G, Castiglione G, Sforza D, Giuseppe N, Bassetti M, Ferraro F, Clementi S, Alessandro D, Cotogni P, Ranieri MV, Antonelli M, Martinelli L, Gianesello L, Gullo A, Morelli A, Biancofiore G, Della Rocca G, Hashimoto S, Onodera M, Kobayashi A, Shinozuka T, Imanaka H, Ikeda T, Yaguchi A, Misane I, Piebalga A, Moughaghab A, Pilvinis V, Vosylius S, Balciunas M, Kekstas G, Margaret H, Klop M, Grozdanovski K, Eftimova B, Wafa S, Lim C, Mat Nor M, Tai L, Tahir SS, Idris N, Tan C, Borg M, Manzo E, Gutierrez Morales H, Miguel P, Villagomez A, Bassols A, Aguirre G, Cerón U, Lopez Ramos J, Monjardín J, Bermudez Aceves E, Gonzalez Salazar F, Rodriguez Gonzalez D, Poblano-Morales M, Ramirez F, Cetina M, Navarro J, Villagomez Ortiz A, Sanchez V, Chavarria U, Fernandez-Ponce O, Serna Secundino H, Leonardo O, Diego Manuel R, Mijangos J, Vazquez de Anda G, Martin E, Gutierrez P, López Islas I, Soberanes L, Ljubica P, Sbihi A, Ouahid B, Naoufel M, De Pont A, Rosseel P, Ten Cate J, Van Berkel G, Corsten S, Bakker J, Vogelaar J, Blom H, Kieft H, Kuiper M, Gille A, Pickkers P, Vet J, Ammann J, Den Boer S, Ziekenhuis S, Wesselink R, Speelberg B, Pham C, Rodgers M, Bergmans D, Groeneveld J, McArthur C, Parke R, Mehrtens J, Celi L, Freebairn R, Rankin N, Heffernan C, McHugh G, Beca J, Van Haren F, Barry B, Kalkoff M, Loevstad R, Klepstad P, Erno P, Junker A, Naqvi S, Javed I, Sinclair J, Rivera R, Chavez C, Donayre Taber Z, Quispe Sierra R, Muñoz J, Galvez Ruiz J, Li JF, Candiotti Herrera M, Arroyo A, Becerra R, Meza J, Mayorga M, Garba P, Kot J, Gaszynski T, Piechota M, Renata S, Müller P, Stepinska J, Jacek K, Cieniawa T, Mikstacki A, Tamowicz B, Bartkowska-Sniatkowska A, Karpel E, Kusza K, Smuszkiewicz P, Mikaszewska-Sokolewicz M, Goraj R, Kubler A, Bártolo A, Castelo-Branco Sousa M, Esteves F, Martins A, Oliveira T, Ponce P, Mourão L, Febra C, Carmo E, Lopes V, Póvoa P, Rezende A, Costa H, Moreira P, Pádua F, Leite A, Almeida E, Alves M, Sousa A, Telo L, Dias C, Paiva J, Ribeiro R, Amaro P, Carneiro A, Moreno R, Matos R, Afonso S, Bouw M, França C, Ibrahim A, Tabacaru R, Ionita V, Tulbure D, Filipescu D, Pascanu S, Grigoras I, Copotoiu S, Popov D, Lebedev E, Olga I, Yaroshetskiy A, Lugovkina T, Dmitry B, Malinin O, Lekmanov A, Abulmagd M, Arabi Y, Alhashemi J, Ali A, Maghrabi K, Debek A, Malik M, Jankovic R, Palibrk I, Maravic-Stojkovic V, Malenkovic V, Surbatovic M, Bumbasirevic V, Lim N, Loh T, Tan H, Sekeresova H, Koutun J, Firment J, Malik P, Trenkler S, Muzlovic I, Kosec L, Ozek B, Kasnik D, Tomic V, Knafelj R, Svigelj V, Du Plesis H, Raine R, Bhagwanjee S, Richards G, Scribante J, Goosen J, De Jager J, Schleicher G, Rubio O, Mañez R, Burgueño Campiñez M, Alvarez M, Jorda R, Naveira-Abeigón E, Monedero P, Alemparte-Pardavila E, Garcia del Valle S, Perez Calvo C, Palomar M, Guerrero F, Caballero Zirena A, Arribas M, Bustamante Munguira E, Ruiz J, Iglesias L, Zavala E, Valencia M, Blesa Malpica A, Martinez-Sagasti F, Nieto M, Aguilar G, Martinon-Torres F, Lorente C, Insausti J, Vegas Pinto R, Santos I, Escriba A, Olaechea P, Muñoz E, Caraballo EA, Galdos-Anuncibay P, Lopez Camps V, Esteban-Reboll F, Estella A, Bocero L, Ibañez A, Pueyo L, Jesús LM, Iglesias L, Silva J, Garro P, Ramos-Gómez L, Rovira A, Delgado MM, Monton Dito J, Garcia F, Navarro J, Latour-Perez J, Albaya A, Bustinza A, Sole-Violán J, Ugarte Peña P, Yuste I, De Rojas Román J, Vallés J, Esteban E, Quintana Tort-Martorell E, Moreno M, López Ciudad V, Manzano Ramirez A, Sánchez-Olmedo J, Borges M, Amador Amerigo J, Guerrero Gomez F, Montejo González J, de la Torre-Prados M, Sirvent J, Mesalles Sanjuan E, Barcenilla-Gaite F, Serrano N, Cerdá E, Lesmes Serrano A, Garcia-Fuentes C, Macias Pingarrón J, Espinosa E, Sanchez Garcia M, Felices F, Jesus HM, Luis V, Jara R, Briones Lopez M, Posada P, Paz HL, Galvan B, Mariscal F, Rello J, Gil B, Sierra R, Rico-Feijoo J, Corcobado Márquez C, Izura J, González J, Soto Ibáñez J, Agabani H, Petersen P, Johansson L, Blomqvist H, Peterzén B, Wyon N, Lindström I, Paulsson A, Agvald-Ohman C, Petersson J, Friberg H, Einar V, Hammarskjöld F, Schindele M, Arvidsson S, Sellgren J, Hulting J, Häggqvist J, Rudenstam J, Lind D, Kokinsky E, Owall A, Jacobson S, Stiernstrom H, Nydahl A, Eggimann P, Stocker R, Loderer G, Loetscher R, Mehlig A, Heer K, Zender H, Cottini S, Pagnamenta A, Eich G, Felleiter P, Maggiorini M, 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Muench C, Robinson S, Crerar-Gilbert A, Rhodes A, Mahambrey T, Cameron L, Thornton J, Stotz M, Russell M, Longmate A, Kitson R, Browne B, Thorniley A, Gonzalez I, Swart M, Singer M, Gautam N, Prasad V, Watson D, Szakmany T, Cardy J, Binning A, Loveland R, Gannon J, Martinelli G, Nightingale P, Howes J, Steingrub J, Ammons L, Fisher M, Gandhi N, Martin G, Deutschman C, Dean N, Michetti C, Belzberg H, Hutchinson K, Van der Kloot T, Afessa B, Kaufman D, Iqbal J, Ost D, West M, Wunderink R, Afifi S, Stein S, Hagg D, Jimenez E, Blosser S, Chhangani S, Kleinpell R, Reich H, Fileds E, Willms D, Castellanos-Mateus P, Melnik L, Oud L, Chi E, Brown Y, Halfon R, Badr A, Restrepo M, Castellanos-Mateus P, Pohlman A, Branson R, Simpson S, Kett D, Jacobs T, Park P, Wahl W, Patricia C, Hammersley J, Papadimos T, Sawyer R, Freire A, Rodriguez W, Ryan A, Margolis B, Groth M, Escanda H, Baraibar J, Paciel D, Bagnulo H, Hitta F, Nadales P, Albornoz H, Salmen Z, Pacheco C, Bui T, Potie F, Huu CN.

Abstract

BACKGROUND:

Abdominal infections are frequent causes of sepsis and septic shock in the intensive care unit (ICU) and are associated with adverse outcomes. We analyzed the characteristics, treatments and outcome of ICU patients with abdominal infections using data extracted from a one-day point prevalence study, the Extended Prevalence of Infection in the ICU (EPIC) II.

METHODS:

EPIC II included 13,796 adult patients from 1,265 ICUs in 75 countries. Infection was defined using the International Sepsis Forum criteria. Microbiological analyses were performed locally. Participating ICUs provided patient follow-up until hospital discharge or for 60 days.

RESULTS:

Of the 7,087 infected patients, 1,392 (19.6%) had an abdominal infection on the study day (60% male, mean age 62 ± 16 years, SAPS II score 39 ± 16, SOFA score 7.6 ± 4.6). Microbiological cultures were positive in 931 (67%) patients, most commonly Gram-negative bacteria (48.0%). Antibiotics were administered to 1366 (98.1%) patients. Patients who had been in the ICU for ≤ 2 days prior to the study day had more Escherichia coli, methicillin-sensitive Staphylococcus aureus and anaerobic isolates, and fewer enterococci than patients who had been in the ICU longer. ICU and hospital mortality rates were 29.4% and 36.3%, respectively. ICU mortality was higher in patients with abdominal infections than in those with other infections (29.4% vs. 24.4%, p < 0.001). In multivariable analysis, hematological malignancy, mechanical ventilation, cirrhosis, need for renal replacement therapy and SAPS II score were independently associated with increased mortality.

CONCLUSIONS:

The characteristics, microbiology and antibiotic treatment of abdominal infections in critically ill patients are diverse. Mortality in patients with isolated abdominal infections was higher than in those who had other infections.

PMID:
25074742
PMCID:
PMC4122779
DOI:
10.1186/1471-2334-14-420
[Indexed for MEDLINE]
Free PMC Article

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