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1. Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection

Author

Martin Loeches, I, Lisboa, T, Rhodes, A, Moreno, Rp, Silva, E, Sprung, C, Chiche, Jd, Barahona, D, Villabon, M, Balasini, C, Pearse, Rm, Matos, R, Rello, J, Rodriguez, A, Capuzzo, M, Reina, R, Marsh, B, Flaaten, H, Sigurdsson, G, Ivana, Z, Cerny, V, Quintel, M, Welte, T, Mayorga, M, Offenstadt, G, Guidet, B, Levin, P, Rothen, Hu, Gomersall, C, Hashemian, Sm, Katsanoulas, C, Mouloudi, H, Kapadia, F, Valentin, A, Hedenstierna, G, Perner, A, Bugedo, G, Ruokonen, E, Soriano Arandes, A, Montejo, Jc, Peñíscola, R, Hermosa, C, Gordo, F, Latour, J, Vidaur, L, Alvarez Gonzalez, M, Alvarez Rocha, L, De Pablo, A, Ferri, C, Lopez De Arbina Martinez, Cânones, C, Insausti, J, Cambronero, J, Galvan, B, Luna, J, Blancas, R, Garcia, C, Sierra, R, Fernández Dorado, F, Monedero, P, Llagunes, J, Cobo, P, Socias, A, Leon Lopez, R, Esteban, E, Lacueva, M, Magret, M, Del Nogal, F, Dinis, A, Bártolo, A, Ramos, A, Franca, C, Estevens, C, Granja, C, Fidalgo, C, Almeida, E, Lafuente, E, Rua, F, Esteves, F, Clemente, J, Nóbrega, Jj, Pereira, Jm, Moura, Jp, Silva LP, Trindade E., Telo, L, Santos, L, Pedrosa, Mj, Oliveira, M, Resende, M, Catorze, N, Coutinho, P, Ribeiro, R, Miranda, I, Cardoso, T, Branco, V, Bellani, G, Urbino, R, Peris, A, Amatu, A, Berlot, G, Marzani, Fc, Corbanese, U, David, Antonio, Chiarandini, P, Della Corte, F, Caspani, Ml, Conio, A, Mangani, V, Tetamo, R, Wolfler, A, Tappatà, G, Vivaldi, N, Bertolini, G, Pelagalli, L, Molin, A, Girardis, M, Gristin, G, Lam, A, Crabb, I, Cusack, R, Jackson, R, Veerappan, C, Whiteley, C, Ware, T, Krueper, S, Mckinstry, C, Ferguson, A, Rubulotta, F, Valencia, E, Gonzalez, S, Cevallos, V, Zazu, A, Chaparro Fresco JN, Galindez, G, Barrios, C, Lovesio, C, Villamagua, B, Cadena, M, Salgado, E, García, Mf, Paredes, G, Donnelly, M, O'Croinin, D, Bates, J, Kavanagh, N, O'Brien, B, Plant, R, Scully, M, Farragher, R, Oliveira, L, Mataloun, S, Dantas, Vs, Simvoulidis, L, Duarte, P, Grion, C, Germano, A, Laake, Jh, Helset, E, Klausen, D, Flaatten, H, Bruheim, K, Kristinsson, B, Sigurdsson, Se, Hrubý, J, Valkova, R, Janda, R, Zykova, I, Kernchen, A, Bloos, F, Rosseau, S, Krassler, J, Fischer, F, Arroyo Sanchez, A, Barrionuevo Poquet, A, Ramos Palomino, I, Rafael, F, Salasfoch, J, Dubar, G, Tonnelier, Jm, Barbar, S, Dobrzynski, M, Mignon, A, Jakobson, D, Klein, M, Segal, E, Barlavie, Y, Hersch, M, Salomón, Zs, Zender, H, Chan, K, Buckley, T, Batranovic, U, Schaffer, I, Sretkovic, J, Koulenti, D, Mouloudi, E, Clouva Molyvdas PM, Gurjar, M, Vijayan, D, Hinterholzer, G, Kulier, A, Verlaat, C, Ebel, D, Persson, J, Walther, S, Petersen, P, Swinnen, W, Collin, V, Olsen, H, Gutierrez, P, Thiery, G, Laine, H, Rumba, A, Maiyalagan, S, Bui, T., Martin-Loeches, I., Lisboa, T., Rhodes, A., Moreno, R. P., Silva, E., Sprung, C., Chiche, J. -D., Barahona, D., Villabon, M., Balasini, C., Pearse, R., Matos, R., Rello, J., Rodriguez, A., Capuzzo, M., Reina, R., Marsh, B., Flaaten, H., Sigurdsson, G., Ivana, Z., Cerny, V., Quintel, M., Welte, T., Mayorga, M., Offenstadt, G., Guidet, B., Levin, P., Rothen, H. -U., Gomersall, C., Hashemian, S. M., Katsanoulas, C., Mouloudi, H., Kapadia, F., Valentin, A., Hedenstierna, G., Perner, A., Bugedo, G., Ruokonen, E., Arandes, A. S., Montejo, J. C., Peniscola, R., Hermosa, C., Gordo, F., Latour, J., Vidaur, L., Alvarez-Gonzalez, M., Alvarez-Rocha, L., De Pablo, A., Ferri, C., De Arbina Martinez, L., Canones, C., Insausti, J., Cambronero, J., Galvan, B., Luna, J., Blancas, R., Garcia, C., Sierra, R., Dorado, F. F., Monedero, P., Llagunes, J., Cobo, P., Socias, A., Leon-Lopez, R., Esteban, E., Lacueva, M., Magret, M., Del Nogal, F., Dinis, A., Bartolo, A., Ramos, A., Franca, C., Estevens, C., Granja, C., Fidalgo, C., Almeida, E., Lafuente, E., Rua, F., Esteves, F., Clemente, J., Nobrega, J. J., Pereira, J. M., Moura, J. P., Trindade E Silva, L. P., Telo, L., Santos, L., Pedrosa, M. J., Oliveira, M., Resende, M., Catorze, N., Coutinho, P., Ribeiro, R., Moreno, R., Miranda, I., Cardoso, T., Branco, V., Bellani, G., Urbino, R., Peris, A., Amatu, A., Berlot, G., Marzani, F. C., Corbanese, U., David, A., Chiarandini, P., Corte, F. D., Caspani, M. L., Alessandra, C., Mangani, V., Tetamo, R., Wolfler, A., Tappata, G., Nicoletta, V., Bertolini, G., Pelagalli, L., Molin, A., Girardis, M., Gristin, G., Lam, A., Crabb, I., Cusack, R., Jackson, R., Veerappan, C., Whiteley, C., Ware, T., Krueper, S., Mckinstry, C., Ferguson, A., Rubulotta, F., Valencia, E., Gonzalez, S., Cevallos, V., Zazu, A., Fresco, J. N. C., Galindez, G., Barrios, C., Lovesio, C., Villamagua, B., Cadena, M., Salgado, E., Garcia, M. F., Paredes, G., Donnelly, M., O'Croinin, D., Bates, J., Kavanagh, N., O'Brien, B., Plant, R., Scully, M., Farragher, R., Oliveira, L., Mataloun, S., Dantas, V. S., Simvoulidis, L., Duarte, P., Grion, C., Germano, A., Laake, J. H., Helset, E., Klausen, D., Flaatten, H., Bruheim, K., Kristinsson, B., Sigurdsson, S. E., Hruby, J., Valkova, R., Janda, R., Zykova, I., Kernchen, A., Bloos, F., Rosseau, S., Krassler, J., Fischer, F., Arroyo-Sanchez, A., Poquet, A. B., Palomino, I. R., Rafael, F., Salasfoch, J., Dubar, G., Tonnelier, J. -M., Barbar, S., Dobrzynski, M., Mignon, A., Jakobson, D., Klein, M., Segal, E., Barlavie, Y., Hersch, M., Salomon, Z. S., Zender, H., Rothen, H. U., Chan, K., Buckley, T., Batranovic, U., Schaffer, I., Sretkovic, J., Koulenti, D., Mouloudi, E., Clouva-Molyvdas, P. -M., Gurjar, M., Vijayan, D., Hinterholzer, G., Kulier, A., Verlaat, C., Ebel, D., Persson, J., Walther, S., Petersen, P., Swinnen, W., Collin, V., Olsen, H., Gutierrez, P., Thiery, G., Laine, H., Rumba, A., Maiyalagan, S., Bui, T., Martin Loeches, I, Lisboa, T, Rhodes, A, Moreno, R, Silva, E, Sprung, C, Chiche, J, Barahona, D, Villabon, M, Balasini, C, Pearse, R, Matos, R, Rello, J, and Pesenti, A

Subjects
Registrie, Male, Original, H1N1 Influenza, Adrenal Cortex Hormone, Critical Care and Intensive Care Medicine, Severity of Illness Index, law.invention, Influenza A Virus, H1N1 Subtype, Community-acquired pneumonia, Adrenal Cortex Hormones, law, Prospective Studies, Registries, 610 Medicine & health, Prospective cohort study, H1N1 Subtype, Influenza, Acute Respiratory Distress Syndrome, Cross Infection, Likelihood Functions, COPD, Acinetobacter, Hazard ratio, Middle Aged, Likelihood Function, Intensive care unit, Europe, Intensive Care Units, Community acquired pneumonia, Corticosteroid therapy, Pandemic (H1N1)v influenza A infection, Female, Survival Analysi, Human, Adult, medicine.medical_specialty, Chronic Obstructive Pulmonary Disease, ARDS, Community acquired pneumonia, Corticosteroid therapy, Pandemic (H1N1)v influenza A infection, Intensive Care Unit, Internal medicine, Correspondence, Influenza, Human, Severity of illness, medicine, Humans, H1N1 Subtype, Intensive care medicine, Pandemics, Pandemic, business.industry, Pneumonia, Odds ratio, medicine.disease, Survival Analysis, Influenza, Asthma, Prospective Studie, business
Abstract

Introduction: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial. Methods: Prospective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry. Results: Two hundred twenty patients admitted to an intensive care unit (ICU) with completed outcome data were analyzed. Invasive mechanical ventilation was used in 155 (70.5%). Sixty-seven (30.5%) of the patients died in ICU and 75 (34.1%) whilst in hospital. One hundred twenty-six (57.3%) patients received corticosteroid therapy on admission to ICU. Patients who received corticosteroids were significantly older and were more likely to have coexisting asthma, chronic obstructive pulmonary disease (COPD), and chronic steroid use. These patients receiving corticosteroids had increased likelihood of developing hospital-acquired pneumonia (HAP) [26.2% versus 13.8%, p < 0.05; odds ratio (OR) 2.2, confidence interval (CI) 1.1-4.5]. Patients who received corticosteroids had significantly higher ICU mortality than patients who did not (46.0% versus 18.1%, p < 0.01; OR 3.8, CI 2.1-7.2). Cox regression analysis adjusted for severity and potential confounding factors identified that early use of corticosteroids was not significantly associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections. associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections. © Copyright jointly held by Springer and ESICM 2010.

Published
2011
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2. Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units

Author

Vogelaers, Dirk, Blot, Stijn, Van den Berge, Andries, Montravers, Philippe, Francois, Guy, Labeau, Sonia, Blot, Koen, Deschepper, Mieke, Antonelli, Massimo, Lipman, Jeffrey, Lamrous, Amin, Pereyra, Cecilia, Lipovestky, Fernando, Koulenti, Despoina, De Waele, Jan, Rezende-Neto, Joao, Cardenas, Yenny, Vymazal, Tomas, Fjeldsoee-Nielsen, Hans, Kott, Matthias, Kostoula, Arvaniti, Javeri, Yash, Girardis, Massimo, Einav, Sharon, de Lange, Dylan, Makikado, Luis Daniel Umezawa, Mikstacki, Adam, Paiva, José-Artur, Tomescu, Dana, Gritsan, Alexey, Jovanovic, Bojan, Venkatesan, Kumaresh, Mirkovic, Tomislav, Maseda, Emilio, Dikmen, Yalim, Creagh-Brown, Benedict, Emmerich, Monica, Canale, Mariana, Dietz, Lorena Silvina, Ilutovich, Santiago, Miñope, John Thomas Sanchez, Silva, Ramona Baldomera, Montenegro, Martin Alexis, Martin, Patricio, Saul, Pablo, Chediack, Viviana, Sutton, Giselle, Couce, Rocio, Balasini, Carina, Gonzalez, Susana, Lascar, Florencia Maria, Descotte, Emiliano Jorge, Gumiela, Natalia Soledad, Pino, Carina Alejandra, Cesio, Cristian, Valgolio, Emanuel, Cunto, Eleonora, Dominguez, Cecilia, Nelson, Nydia Funes, Abegao, Esteban Martin, Pozo, Norberto Christian, Bianchi, Luciana, Correger, Enrique, Pastorino, Maria Laura, Miyazaki, Erica Aurora, Grubissich, Nicolas, Garcia, Mariel, Bonetto, Natalia, Quevedo, Noelia Elizabeth, Gomez, Cristina Delia, Queti, Felipe, Estevarena, Luis Gonzalez, Fernandez, Ruben, Santolaya, Ignacio, Grangeat, Sergio Hugo, Doglia, Juan, Zakalik, Graciela, Pellegrini, Carlos, Lloria, Maria Monserrat, Chacon, Mercedes Esteban, Fumale, Mariela, Leguizamon, Mariela, Hidalgo, Irene Beatriz, Tiranti, Roberto Julian, Capponi, Paola, Tita, Agustin, Cardonnet, Luis, Bettini, Lisandro, Ramos, Agñel, Lovesio, Luciano, Miranda, Edith Miriam, Farfan, Angelica Beatriz, Tolosa, Carina, Segura, Lise, Bellocchio, Adelina, Alvarez, Brian, Manzur, Adriana, Lujan, Rodolfo, Fernandez, Natalia, Scarone, Nahuel, Zazu, Alan, Groh, Carina, Fletcher, Jason, Smith, Julie, Azad, Raman, Chavan, Nitin, Wong, Helen, Kol, Mark, Campbell, Lewis, Starr, Therese, Roberts, Brigit, Wibrow, Bradley, Warhurst, Timothy, Chinthamuneedi, Meher, Ferney, Bernal Buitrago, Simon, Marc, De Backer, Daniel, Wittebole, Xavier, De Bels, David, Collin, Vincent, Dams, Karolien, Jorens, Philippe, Dubois, Jasperina, Gunst, Jan, Haentjens, Lionel, De Schryver, Nicolas, Dugernier, Thierry, Rizoli, Sandro, Santillan, Paul, Han, Yi, Biskup, Ewelina, Qu, Changjing, Li, Xinyu, Yu, Tao, Weihua, Lu, Molano-Franco, Daniel, Rojas, José, Oviedo, Juan Mauricio Pardo, Pinilla, Dario, Celis, Edgar, Arias, Mario, Vukovic, Anita, Vudrag, Maja, Belavic, Matija, Zunic, Josip, Kuharic, Janja, Kricka, Irena Bozanic, Filipovic-Grcic, Ina, Tomasevic, Boris, Obraz, Melanija, Bodulica, Bruna, Dohnal, Martin, Malaska, Jan, Kratochvil, Milan, Satinsky, Igor, Schwarz, Peter, Kos, Zdenek, Blahut, Ladislav, Maca, Jan, Protus, Marek, Kieslichová, Eva, Nielsen, Louise Gramstrup, Krogh, Birgitte Marianne, Rivadeneira, Francisco, Morales, Freddy, Mora, José, Orozco, Alexandra Saraguro, MorochoTutillo, Diego Rolando, Vargas, Nelson Remache, Yepez, Estuardo Salgado, Villamagua, Boris, Alsisi, Adel, Fahmy, Abdelraouf, Dupont, Hervé, Lasocki, Sigismond, Paugam-Burtz, Catherine, Foucrier, Arnaud, Nica, Alexandru, Barjon, Geneviève, Mallat, Jihad, Marcotte, Guillaume, Leone, Marc, Duclos, Gary, Burtin, Philippe, Atchade, Enora, Mahjoub, Yazine, Misset, Benoît, Timsit, Jean-François, Dupuis, Claire, Veber, Benoît, Debarre, Matthieu, Collange, Oliver, Pottecher, Julien, Hecketsweiler, Stephane, Fromentin, Mélanie, Tesnière, Antoine, Koch, Christian, Sander, Michael, Eckmann, Christian, Elke, Gunnar, Wrigge, Hermann, Simon, Philipp, Chalkiadaki, Anthoula, Tzanidakis, Charalampos, Pneumatikos, Ioannis, Sertaridou, Eleni, Mastora, Zafiria, Pantazopoulos, Ioannis, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi, Floros, John, Kolonia, Virginia, Dimopoulos, George, Diakaki, Chryssa, Rallis, Michael, Paridou, Alexandra, Kalogeromitros, Alexandros, Romanou, Vasiliki, Nikolaou, Charikleia, Kounougeri, Katerina, Tsigou, Evdoxia, Psallida, Vasiliki, Karampela, Niki, Mandragos, Konstantinos, Kontoudaki, Eftychia, Pentheroudaki, Alexandra, Farazi-Chongouki, Christos, Karakosta, Agathi, Chouris, Isaac, Radu, Vasiliki, Malliotakis, Polychronis, Kokkini, Sofia, Charalambous, Eliana, Kyritsi, Aikaterini, Koulouras, Vasilios, Papathanakos, Georgios, Nagky, Eva, Lampiri, Clairi, Tsimpoukas, Fotios, Sarakatsanos, Ioannis, Georgakopoulos, Panagiotis, Ravani, Ifigeneia, Prekates, Athanasios, Sakellaridis, Konstantinos, Christopoulos, Christos, Vrettou, Efstratia, Stokkos, Konstantinos, Pentari, Anastasia, Arvaniti, Kostoula, Marmanidou, Kyriaki, Kydona, Christina, Tsoumaropoulos, Georgios, Bitzani, Militisa, Kontou, Paschalina, Voudouris, Antonios, Elli-Nikki, [missing], Flioni, [missing], Antypa, Elli, Chasou, Eleftheria, Anisoglou, Souzana, Papageorgiou, Eirini, Paraforou, Theoniki, Tsioka, Agoritsa, Karathanou, Antigoni, Vakalos, Aristeidis, Shah, Bhagyesh, Thakkar, Chirag, Jain, Nikhilesh, Gurjar, Mohan, Baronia, Arvind, Sathe, Prachee, Kulkarni, Shilpa, Paul, Cherish, Paul, John, Masjedi, Mansoor, Nikandish, Reza, Zand, Farid, Sabetian, Golnar, Mahmoodpoor, Ata, Hashemian, Seyed Mohammadreza, Bala, Miklosh, Flocco, Romeo, Torrente, Sergio, Pota, Vincenzo, Spadaro, Savino, Volta, Carlo, Serafini, Giulia, Boraso, Sabrina, Tiberio, Ivo, Cortegiani, Andrea, Misseri, Giovanni, Barbagallo, Maria, Nicolotti, Davide, Forfori, Francesco, Corradi, Francesco, De Pascale, Gennaro, Pelagalli, Lorella, Brazzi, Luca, Vittone, Ferdinando Giorgio, Russo, Alessandro, Simion, Davide, Cotoia, Antonella, Cinnella, Gilda, Toppin, Patrick, Johnson-Jackson, Roxanne, Hayashi, Yoshiro, Yamamoto, Ryohei, Yasuda, Hideto, Kishihara, Yuki, Shiotsuka, Junji, Sanchez-Hurtado, Luis Alejandro, Tejeda-Huezo, Brigitte, Gorordo, Luis, Ñamendys-Silva, Silvio A., Garcia-Guillen, Francisco J., Martinez, Manuel, Romero-Meja, Erick, Colorado-Dominguez, Ever, van den Oever, Huub, Kalff, Karel Martijn, Vermeijden, Wytze, Cornet, Alexander Daniel, Beck, Oliver, Cimic, Nedim, Dormans, Tom, Bormans, Laura, Bakker, Jan, Van Duijn, Ditty, Bosman, Gerrit, Vos, Piet, Haas, Lenneke, Henein, Akram, Miranda, Ariel M., Malca, Gonzalo Ernesto Gianella, Arroyo-Sanchez, Abel, Misiewska-Kaczur, Agnieszka, Akinyi, Frisch, Czuczwar, Miroslaw, Luczak, Karolina, Sulkowski, Wiktor, Tamowicz, Barbara, Swit, Beata, Baranowski, Bronisław, Smuszkiewicz, Piotr, Trojanowska, Iwona, Rzymski, Stanislaw, Sawinski, Mariusz, Trosiak, Marta, Mikaszewska-Sokolewicz, Malgorzata, Alves, Ricardo, Leal, Dina, Krystopchuk, Andriy, Mendonca, Pedro Muguel Hilario, Pereira, Rui Antunes, de Carvalho, Maria Raquel Lopes Marques, Candeias, Carlos, Molinos, Elena, Ferreira, Amélia, Castro, Guiomar, Pereira, José-Manuel, Santos, Lurdes, Ferreira, Alcina, Pascoalinho, Dulce, Ribeiro, Rosa, Domingos, Guilherme, Gomes, Pedro, Nora, David, Costa, Rui Pedro, Santos, Anabela, Alsheikhly, Ahmed Subhy, Popescu, Mihai, Grigoras, Ioana, Patrascanu, Emilia, Zabolotskikh, Igor, Musaeva, Tatiana, Gaigolnik, Denis, Kulabukhov, Vladimir, Belskiy, Vladislav, Zubareva, Nadezhda, Tribulev, Maxim, Abdelsalam, Ahmed, Aldarsani, Ayman, Al-Khalid, Muhammad, Almekhlafi, Ghaleb, Mandourah, Yasser, Doklestic, Krstina, Velickovic, Jelena, Velickovic, Dejan, Jankovic, Radmilo, Skoric-Jokic, Svetlana, Radovanovic, Dragana, Richards, Guy, Alli, Ahmad, Del Carmen Cordoba Nielfa, Maria, Iniesta, Rafael Sánchez, Martínez, Adela Benítez-Cano, Bernedo, Carlos Garcia, Gil, Santiago Alberto Picos, Nuvials, Xavier, Rello, Jordi, Garcia, Joseba Gonzalez, Peña, Jose Manuel Garcia, Jimenez, Roberto, Herrera, Luis, Barrachina, Laura Galarza, Monzon, Ignacio Catalan, Redondo, Francisco Javier, Villazala, Ruben, Zapata, Diego Fernando Matallana, Lopez, Isabel Maria Villa, Moreno-Gonzalez, Gabriel, Lopez-Delgado, Juan Carlos, Marin, Jorge Solera, Sanchez-Zamora, Purificacion, Vidal, Montserrat Vallverdú, González, Jesús Flores, Salinas, Irene, Hermosa, Cecilia, Martinez-Sagasti, Fernando, Domingo-Marín, Sara, Victorino, Johanna Abril, Garcia-Alvarez, Raquel, Calleja, Pablo López-Arcas, de la Torre-Prados, Maria-Victoria, Vidal-Cortes, Pablo, Del Río-Carbajo, Lorena, Izura, Javier, Minguez, Victoria, Alvarez, Josep Trenado, Prous, Anna Parera, Paz, Daniel, Roche-Campo, Ferran, Aguilar, Gerardo, Belda, Javier, Rico-Feijoo, Jesus, Aldecoa, Cesat, Zalba-Etayo, Begoña, Lang, Martin, Dullenkopf, Alexander, Trongtrakul, Konlawij, Chtsomkasem, Anusang, Akbaş, Türkay, Unal, Mustafa Necmettin, Ozcelik, Menekse, Gumus, Ayca, Ramazanoglu, Atilla, Memis, Dilek, Mehmet, Inal, Urkmez, Seval, Ozgultekin, Asu, Demirkiran, Oktay, Aslan, Nesrin Ahu, Kizilaslan, Deniz, Kahveci, Ferda, Ünlü, Nurdan, Ozkan, Zeynep, Kaye, Callum, Jansen, Jan, O’Neill, Orla, Nutt, Christopher, Jha, Rajeev, Hooker, Nicolas, Grecu, Irina, Petridou, Christina, Shyamsundar, Murali, McNamee, Lia, Trinder, John, Hagan, Samantha, Kelly, Catriona, Silversides, Jonathon, Groba, Casiano Barrera, Boyd, Owen, Bhowmick, Kaushik, Humphreys, Sally, Summers, Charlotte, Polgarova, Petra, Margarson, Michael, Dickens, Justin, Pearson, Suzanne, Chinery, Elaine, Hemmings, Noel, O’Kane, Sinead, Austin, Pauline, Cole, Stephen, Plowright, Catherine, Box, Roberta, Wright, Christopher, Young, Lorna, Creagh-Brown, Ben, Montague, Laura, Parker, Robert, Morton, Ben, Ostermann, Marlies, Bilinska, Julia, Rose, Bernd Oliver, Reece-Anthony, Rosie, Ryan, Christine, Hamilton, Mark, Hopkins, Philip, Wendon, Julia, Brescia, Giovanni, Ijaz, Nazia, Wood, James, George, Michelle, Toth-Tarsoly, Piroska, Yates, Bryan, Armstrong, Maureen, Scott, Carmen, Boyd, Christine, Szakmany, Tamas, Rees, David, Pulak, Paul, Coggon, Mandy, Saha, Bhaskar, Kent, Linda, Gibson, Bethan, Camsooksai, Julie, Reschreiter, Henrik, Morgan, Pat, Sangaralingham, Sivatharshini, Lowe, Alastair, Vondras, Petr, Jamadarkhana, Sunil, Cruz, Carina, Bhandary, Rakesh, Hersey, Peter, Furneval, Julie, Innes, Richard, Doble, Patricia, Attwood, Ben, Parsons, Penny, Page, Valerie, Zhao, Xiaobei, Dalton, Julian, Hegazy, Mohammed, Awad, Yasser, Naylor, Douglas, Naylor, Amanda, Lee, Sarah, Brevard, Sidney, Davis, Noelle, for the Abdominal Sepsis Study (‘AbSeS’) Group on behalf of the Trials Group of the European Society of Intensive Care Medicine, [missing], Vogelaers D., Blot S., Van den Berge A., Montravers P., Francois G., Labeau S., Blot K., Deschepper M., Antonelli M., Lipman J., Lamrous A., Pereyra C., Lipovestky F., Koulenti D., De Waele J., Rezende-Neto J., Cardenas Y., Vymazal T., Fjeldsoee-Nielsen H., Kott M., Kostoula A., Javeri Y., Girardis M., Einav S., de Lange D., Makikado L.D.U., Mikstacki A., Paiva J.-A., Tomescu D., Gritsan A., Jovanovic B., Venkatesan K., Mirkovic T., Maseda E., Dikmen Y., Creagh-Brown B., 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., Grubissich N., Garcia M., Bonetto N., Quevedo N.E., Gomez C.D., Queti F., Estevarena L.G., Fernandez R., Santolaya I., 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., 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G., Arroyo-Sanchez, A., Misiewska-Kaczur, A., Akinyi, F., Czuczwar, M., Luczak, K., Sulkowski, W., Tamowicz, B., Swit, B., Baranowski, B., Smuszkiewicz, P., Trojanowska, I., Rzymski, S., Sawinski, M., Trosiak, M., Mikaszewska-Sokolewicz, M., Alves, R., Leal, D., Krystopchuk, A., Mendonca, P. M. H., Pereira, R. A., de Carvalho, M. R. L. M., Candeias, C., Molinos, E., Ferreira, A., Castro, G., Pereira, J. -M., Santos, L., Pascoalinho, D., Ribeiro, R., Domingos, G., Gomes, P., Nora, D., Costa, R. P., Santos, A., Alsheikhly, A. S., Popescu, M., Grigoras, I., Patrascanu, E., Zabolotskikh, I., Musaeva, T., Gaigolnik, D., Kulabukhov, V., Belskiy, V., Zubareva, N., Tribulev, M., Abdelsalam, A., Aldarsani, A., Al-Khalid, M., Almekhlafi, G., Mandourah, Y., Doklestic, K., Velickovic, J., Velickovic, D., Jankovic, R., Skoric-Jokic, S., Radovanovic, D., Richards, G., Alli, A., Del Carmen Cordoba Nielfa, M., Iniesta, R. S., Martinez, A. B. -C., Bernedo, C. G., Gil, S. A. 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A., Kizilaslan, D., Kahveci, F., Unlu, N., Ozkan, Z., Kaye, C., Jansen, J., O'Neill, O., Nutt, C., Jha, R., Hooker, N., Grecu, I., Petridou, C., Shyamsundar, M., Mcnamee, L., Trinder, J., Hagan, S., Kelly, C., Silversides, J., Groba, C. B., Boyd, O., Bhowmick, K., Humphreys, S., Summers, C., Polgarova, P., Margarson, M., Dickens, J., Pearson, S., Chinery, E., Hemmings, N., O'Kane, S., 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., Dalton, J., Hegazy, M., Awad, Y., Naylor, D., Naylor, A., Lee, S., Brevard, S., and Davis, N.

Subjects
Drug Resistance, medicine.disease_cause, Severity of Illness Index, law.invention, 0302 clinical medicine, ENTEROBACTERIACEAE, law, Drug Resistance, Multiple, Bacterial, Medicine and Health Sciences, Pharmacology (medical), Cross Infection, biology, Bacterial, Antimicrobial, Intensive care unit, Anti-Bacterial Agents, Community-Acquired Infections, Europe, Intensive Care Units, Critical Illness, Humans, Intraabdominal Infections, Microbial Sensitivity Tests, Peritonitis, Sepsis, ESCHERICHIA-COLI, 030220 oncology & carcinogenesis, KLEBSIELLA-PNEUMONIAE, BLOOD-STREAM INFECTIONS, PYELONEPHRITIS, Multiple, medicine.medical_specialty, Enterococcus faecalis, NO, 03 medical and health sciences, Intra‑abdominal Infections, Antibiotic resistance, FOOD, Intensive care, Internal medicine, medicine, FLUOROQUINOLONE RESISTANCE, Pseudomonas aeruginosa, business.industry, Septic shock, MORTALITY, biology.organism_classification, medicine.disease, RISK-FACTORS, business, 030217 neurology & neurosurgery, Enterococcus faecium
Abstract

Severe intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. In this study, we report on resistance profiles of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis and Enterococcus faecium in distinct European geographic regions based on an observational cohort study on intra-abdominal infections in intensive care unit (ICU) patients. Resistance against aminopenicillins, fluoroquinolones, and third-generation cephalosporins in E. coli, K. pneumoniae and P. aeruginosa is problematic, as is carbapenem-resistance in the latter pathogen. For E. coli and K. pneumoniae, resistance is mainly an issue in Central Europe, Eastern and South-East Europe, and Southern Europe, while resistance in P. aeruginosa is additionally problematic in Western Europe. Vancomycin-resistance in E. faecalis is of lesser concern but requires vigilance in E. faecium in Central and Eastern and South-East Europe. In the subcohort of patients with secondary peritonitis presenting with either sepsis or septic shock, the appropriateness of empiric antimicrobial therapy was not associated with mortality. In contrast, failure of source control was strongly associated with mortality. The relevance of these new insights for future recommendations regarding empiric antimicrobial therapy in intra-abdominal infections is discussed.

Published
2021
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3. Epidemiology of intra-abdominal infection and sepsis in critically ill patients: 'AbSeS', a multinational observational cohort study and ESICM Trials Group Project

Author

Blot, S. aEmail Author, Antonelli M. b, c Arvaniti, K. d Blot, K. a Creagh-Brown, B. e f, de Lange, D. g, De Waele, J. h Deschepper, M. i Dikmen, Y. j Dimopoulos, G. k Eckmann, C. l Francois, G. m Girardis, M. n Koulenti, D. o p, Labeau S. a, q Lipman, J. r s, Lipovestky F. t, Maseda E. u, Montravers P. v, w Mikstacki, A. x y, Paiva, J. -A. z, Pereyra, C. aa, Rello, J. ab, Timsit, J. -F. ac, ad Vogelaers, D. ae, 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., Emmerich M., Canale M., Dietz L. S., Ilutovich S., Miñope 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., Grubissich N., Garcia M., Bonetto N., Quevedo N. E., Gomez C. D., Queti F., Estevarena L. G., Fernandez R., Santolaya I., 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, De Bels, D. Collin, V. Dams, K. Jorens, P. Dubois, J. Gunst, J. Haentjens, 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. Kieslichová, 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., Tesnière A., Koch C., Sander 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. Kishihara, Y. Shiotsuka, J. Sanchez-Hurtado, L. A. Tejeda-Huezo, B. Gorordo, L. Ñamendys-Silva, S. A. Garcia-Guillen, F. J. Martinez, M. Romero-Meja, E. Colorado-Dominguez, van den Oever, H. Kalff, K. M. Vermeijden, W. Cornet, A. D. Beck, O. Cimic, N. Dormans, T. Bormans, L. Bakker, Van Duijn, D. Bosman, G. Vos, P. Haas, L. Henein, A. Miranda, A. M. Makikado, L. D. U. Malca, G. E. G. Arroyo-Sanchez, A. Misiewska-Kaczur, A. Akinyi, F. Czuczwar, M. Luczak, K. Sulkowski, W. Tamowicz, B. Swit, B. Baranowski, B. Smuszkiewicz, P. Trojanowska, I. Rzymski, S. Sawinski, M. Trosiak, M. Mikaszewska-Sokolewicz, M. Alves, R. Leal, D. Krystopchuk, A. Mendonca, P. M. H. Pereira, R. A., de Carvalho, M. R. L. M. Candeias, C. Molinos, E. Ferreira, A. Castro, G. Pereira, J. -M., Santos L., Ferreira A., Pascoalinho D., Ribeiro R., Domingos G., Gomes P., Nora D., Costa R. P., Santos A., Alsheikhly A. S., Popescu M., Grigoras I., Patrascanu E., Zabolotskikh I., Musaeva T., Gaigolnik D., Kulabukhov V., Belskiy V., Zubareva N., Tribulev M., Abdelsalam A., Aldarsani A., Al-Khalid M., Almekhlafi G., Mandourah Y., Doklestic K., Velickovic J., Velickovic D., Jankovic R., Vukovic A., Skoric-Jokic S., Radovanovic D., Richards G., Alli A., del Carmen Cordoba Nielfa, M. Iniesta, R. S. Martínez, A. B. -C., Bernedo C. G., Gil S. A. P., Nuvials X., Garcia J. G., Peña J. M. G., Jimenez R., Herrera L., Barrachina L. G., Monzon I. C., Redondo F. J., Villazala R., Zapata D. F. M., Lopez I. M. V., Moreno-Gonzalez G., Lopez-Delgado J. C., Marin J. S., Sanchez-Zamora P., Vidal M. V., González J. F., Salinas I., Hermosa C., Martinez-Sagasti F., Domingo-Marín S., Victorino J. A., Garcia-Alvarez R., Calleja, P. L. -A., de la Torre-Prados, M. -V., Vidal-Cortes P., del Río-Carbajo, L. Izura, J. Minguez, V. Alvarez, J. T. Prous, A. P. Paz, D. Roche-Campo, F. Aguilar, G. Belda, J. Rico-Feijoo, J. Aldecoa, C. Zalba-Etayo, B. Lang, M. Dullenkopf, A. Trongtrakul, K. Chtsomkasem, A. Akbas, T. Unal, M. N. Ozcelik, M. Gumus, A. Ramazanoglu, A. Memis, D. Mehmet, I. Urkmez, S. Ozgultekin, A. Demirkiran, O. Aslan, N. A. Kizilaslan, D. Kahveci, F. Ünlü, N. Ozkan, Z. Kaye, C. Jansen, J. O’Neill, O. Nutt, C. Jha, R. Hooker, N. Grecu, I. Petridou, C. Shyamsundar, M. McNamee, L. Trinder, J. Hagan, S. Kelly, C. Silversides, J. Groba, C. B. Boyd, O. Bhowmick, K. Humphreys, S. Summers, C. Polgarova, P. Margarson, M. Dickens, J. Pearson, S. Chinery, E. Hemmings, N. O’Kane, S. 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, University of Queensland [Brisbane], Department of Intensive Care and Anesthesiology, Università cattolica del Sacro Cuore [Milano] (Unicatt), University Medical Center [Utrecht], Johns Hopkins Bloomberg School of Public Health [Baltimore], Johns Hopkins University (JHU), Département d'Anesthésie Réanimation, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centro Hospitalar Universitário São João - Faculty of Medicine - University of Porto - Grupo de Infecção e Sepsis, Porto, Critical Care Department, Joan XXIII University Hospital, Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM), UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, European Soc Intensive Care Med, İÜC, Cerrahpaşa Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, [Blot S, Blot K] Department of Internal Medicine and Pediatrics, Ghent University, Campus UZ Gent, Ghent, Belgium. [Antonelli M] Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Università Cattolica del Sacro Cuore, Rome, Italy. [Arvaniti K] Intensive Care Unit, Papageorgiou University Affiliated Hospital, Thessaloníki, Greece. [Creagh-Brown, B] Surrey Perioperative Anaesthetic Critical Care Collaborative Research Group (SPACeR), Royal Surrey County Hospital, Guildford, UK. Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK. [de Lange D] Department of Intensive Care Medicine, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands. [Rello J] Centro de investigación en red de enfermedades respiratorias (CIBERES), Madrid, Spain. Recerca clínica/Innovació en la pneumònia i sèpsia, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, Ünlü, Nurdan, Kahveci, Ferda, CYR-2043-2022, CHB-0826-2022, Assistance Publique-Hôpitaux de Marseille (AP-HM), 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., 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., Grubissich N., Garcia M., Bonetto N., Quevedo N.E., Gomez C.D., Queti F., Estevarena L.G., Fernandez R., Santolaya I., 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., 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., 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., Dupuis C., Veber B., Debarre M., Collange O., Pottecher J., Hecketsweiler S., Fromentin M., Tesniere A., Koch C., Sander 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., Kishihara Y., Shiotsuka J., Sanchez-Hurtado L.A., Tejeda-Huezo B., Gorordo L., Namendys-Silva S.A., Garcia-Guillen F.J., Martinez M., Romero-Meja E., Colorado-Dominguez E., van den Oever H., Kalff K.M., Vermeijden W., Cornet A.D., Beck O., Cimic N., Dormans T., Bormans L., Bakker J., Van Duijn D., Bosman G., Vos P., Haas L., Henein A., Miranda A.M., Malca G.E.G., Arroyo-Sanchez A., Misiewska-Kaczur A., Akinyi F., Czuczwar M., Luczak K., Sulkowski W., Tamowicz B., Swit B., Baranowski B., Smuszkiewicz P., Trojanowska I., Rzymski S., Sawinski M., Trosiak M., Mikaszewska-Sokolewicz M., Alves R., Leal D., Krystopchuk A., Mendonca P.M.H., Pereira R.A., de Carvalho M.R.L.M., Candeias C., Molinos E., Ferreira A., Castro G., Pereira J.-M., Santos L., Pascoalinho D., Ribeiro R., Domingos G., Gomes P., Nora D., Costa R.P., Santos A., Alsheikhly A.S., Popescu M., Grigoras I., Patrascanu E., Zabolotskikh I., Musaeva T., Gaigolnik D., Kulabukhov V., Belskiy V., Zubareva N., Tribulev M., Abdelsalam A., Aldarsani A., Al-Khalid M., Almekhlafi G., Mandourah Y., Doklestic K., Velickovic J., Velickovic D., Jankovic R., Skoric-Jokic S., Radovanovic D., Richards G., Alli A., del Carmen Cordoba Nielfa M., Iniesta R.S., Martinez A.B.-C., Bernedo C.G., Gil S.A.P., Nuvials X., Garcia J.G., Pena J.M.G., Jimenez R., Herrera L., Barrachina L.G., Monzon I.C., Redondo F.J., Villazala R., Zapata D.F.M., Lopez I.M.V., Moreno-Gonzalez G., Lopez-Delgado J.C., Marin J.S., Sanchez-Zamora P., Vidal M.V., Gonzalez J.F., Salinas I., Hermosa C., Martinez-Sagasti F., Domingo-Marin S., Victorino J.A., Garcia-Alvarez R., Calleja P.L.-A., de la Torre-Prados M.-V., Vidal-Cortes P., del Rio-Carbajo L., Izura J., Minguez V., Alvarez J.T., Prous A.P., Paz D., Roche-Campo F., Aguilar G., Belda J., Rico-Feijoo J., Aldecoa C., Zalba-Etayo B., Lang M., Dullenkopf A., Trongtrakul K., Chtsomkasem A., Akbas T., Unal M.N., Ozcelik M., Gumus A., Ramazanoglu A., Memis D., Mehmet I., Urkmez S., Ozgultekin A., Demirkiran O., Aslan N.A., Kizilaslan D., Kahveci F., Unlu N., Ozkan Z., Kaye C., Jansen J., O'Neill O., Nutt C., Jha R., Hooker N., Grecu I., Petridou C., Shyamsundar M., McNamee L., Trinder J., Hagan S., Kelly C., Silversides J., Groba C.B., Boyd O., Bhowmick K., Humphreys S., Summers C., Polgarova P., Margarson M., Dickens J., Pearson S., Chinery E., Hemmings N., O'Kane S., 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., Dalton J., Hegazy M., Awad Y., Naylor D., Naylor A., Lee S., Brevard S., Davis N., Blot, Stijn [0000-0003-2145-0345], Apollo - University of Cambridge Repository, Gunst, Jan, Epidemiology, Intensive Care, Blot, S., aEmail Author, Antonelli, M. b., C, Arvaniti, Blot, K. d., Creagh-Brown, K. a., B. e., F, De, Lange, D., G., De, Waele, Deschepper, J. h., Dikmen, M. i., Dimopoulos, Y. j., Eckmann, G. k., Francois, C. l., Girardis, G. m., Koulenti, M. n., D. o., P, Labeau, S. a., Q, Lipman, J. r., S, Lipovestky, F. t., Maseda, E. u., Montravers, P. v., W, Mikstacki, A. x., Y, Paiva, J. -A., Z., Pereyra, C., Aa, Rello, J., Ab, Timsit, J. -F., Ac, Ad, Vogelaer, D., Ae, 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., Emmerich, M., Canale, M., Dietz, L. S., Ilutovich, S., Miñope, 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., Grubissich, N., Garcia, M., Bonetto, N., Quevedo, N. E., Gomez, C. D., Queti, F., Estevarena, L. G., Fernandez, R., Santolaya, I., 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, De, Bel, D., Collin, V., Dam, K., Joren, P., Duboi, J., Gunst, J., Haentjen, 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., Roja, J., Oviedo, J. M. P., Pinilla, D., Cardena, Y., Celi, E., Aria, 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., Ko, Z., Blahut, L., Maca, J., Protu, M., Kieslichová, E., Nielsen, L. G., Krogh, B. M., Rivadeneira, F., Morale, F., Mora, J., Orozco, A. S., Morochotutillo, D. R., Varga, 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., Duclo, 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., Tesnière, A., Koch, C., Sander, 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. 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Subjects
Infection risk, Male, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences, Antibiotic resistance, Tracte gastrointestinal - Malalties, Definitions, Critical Care and Intensive Care Medicine, THERAPY, DEFINITIONS, Infections::Intraabdominal Infections [DISEASES], 0302 clinical medicine, Intensive care, Intra-abdominal infection, Mortality, Multidrug resistance, Peritonitis, Sepsis, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Observational study, Septic shock, ComputingMilieux_MISCELLANEOUS, Critical Illness/epidemiology, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti, Intraabdominal Infections/epidemiology, Abdominal infection, Multicenter study, 3. Good health, Management, Clinical trial, Cohort, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Cohort analysis, Community acquired infection, Cohort study, Human, medicine.medical_specialty, Carbapenem resistance, Critical Illness, Peritoneal dialysis, Vancomycin resistant enterococcus, Major clinical study, Article, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Settore MED/41 - ANESTESIOLOGIA, Humans, Critical care medicine, Hospital infection, Aged, Science & Technology, Liver failure, Antibiotic therapy, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Epidemiologic Studies, 030228 respiratory system, Intensive Care Unit, Sepsis (Diptera), Septic Shock, Risk factor, Human medicine, General & internal medicine, Congestive heart failure, Original, Cohort Studies, Risk Factors, Cause of Death, Epidemiology, Prevalence, Medicine and Health Sciences, Abdominal abscess, Sepsis/epidemiology, Middle aged, Antifungal therapy, 2. Zero hunger, Peritoniti, Antibiotic agent, Biliary tract infection, Middle Aged, infecciones bacterianas y micosis::infección::infecciones intraabdominales [ENFERMEDADES], PREVALENCE, Infections::Sepsis [DISEASES], técnicas de investigación::métodos epidemiológicos::características de los estudios epidemiológicos::estudios epidemiológicos::estudios de cohortes [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Methicillin resistant staphylococcus aureus, Raonament basat en casos, Female, Critically ill patient, Life Sciences & Biomedicine, Antifungal agent, Adult, Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics::Epidemiologic Studies::Cohort Studies [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Predictive value, infecciones bacterianas y micosis::infección::sepsis [ENFERMEDADES], NO, Critical Care Medicine, Internal medicine, General & Internal Medicine, medicine, MANAGEMENT, Journal Article, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Septicèmia, business.industry, Pancreas disease, Malnutrition, 030208 emergency & critical care medicine, Typhlitis, Toxic megacolon, Intraabdominal Infections, Therapy, Late onset disorder, business
Abstract

Pardo-Oviedo, Juan Mauricio/0000-0003-0084-3449; Lopez-Delgado, Juan Carlos/0000-0003-3324-1129; Corradi, Francesco/0000-0002-5588-2608; De Backer, Daniel/0000-0001-9841-5762; POTA, VINCENZO/0000-0001-9999-3388; Tomescu, Dana/0000-0001-9673-5754; Sabetian, Golnar/0000-0001-8764-2150; Girardis, Massimo/0000-0002-2453-0829; Brazzi, Luca/0000-0001-7059-0622; Leone, Marc/0000-0002-3097-758X; Zabolotskikh, Igor Borisovich/0000-0002-3623-2546; De Lange, Dylan/0000-0002-0191-7270; ALMEKHLAFI, GHALEB A./0000-0002-0323-7025; Elke, Gunnar/0000-0002-4948-1605; Grigoras, Ioana/0000-0001-9412-9574; Czuczwar, Miroslaw/0000-0002-9025-6717; Nora, David/0000-0002-1133-7368; Masjedi, Mansoor/0000-0001-6175-9289; Gunst, Jan/0000-0003-2470-6393; Vidal-Cortes, Pablo/0000-0003-0225-9975; Szakmany, Tamas/0000-0003-3632-8844; Dimopoulos, George/0000-0002-3784-3103; Rello, Jordi/0000-0003-0676-6210; U nal, Necmettin/0000-0002-9440-7893; Tiberio, Iolanda FLC/0000-0002-5662-7895; Cortegiani, Andrea/0000-0003-1416-9993; Morton, Ben/0000-0002-6164-2854; Labeau, Sonia/0000-0003-3863-612X; Velickovic, Dejan/0000-0002-7312-2880; Paul, John/0000-0002-9307-3465; Pereira, Rui/0000-0002-3010-8384; Silversides, Jon/0000-0002-9562-5462; Paiva, Jose-Artur/0000-0003-4323-0220; Smuszkiewicz, Piotr/0000-0003-3067-8229; Paul, Cherish/0000-0001-6133-0036; Santos, Lurdes/0000-0002-0622-6823; PANTAZOPOULOS, IOANNIS/0000-0002-8846-519X; Ostermann, Marlies/0000-0001-9500-9080; Blot, Stijn/0000-0003-2145-0345; Naylor, Amanda/0000-0002-6431-0230; Shyamsundar, Murali/0000-0003-3797-8080; Aldecoa, Cesar/0000-0001-8789-5959; Summers, Charlotte/0000-0002-7269-2873; biskup, ewelina/0000-0002-9871-927X; Cornet, Alexander/0000-0002-9917-5251; Trenado Alvarez, Jose/0000-0002-2930-0766; Volta, Carlo/0000-0003-3533-6121; Gritsan, Alexey/0000-0002-0500-2887; Urkmez, Seval/0000-0002-3412-4226 WOS:000493268200001 PubMed ID: 31664501 PurposeTo 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. Pfizer investigator-initiated research grant AbSeS is a Trials Group Study of the European Society of Intensive Care Medicine. The study was supported by a Pfizer investigator-initiated research grant.

Published
2019
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