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5. Poor timing and failure of source control are risk factors for mortality in critically ill patients with secondary peritonitis

Author

De Pascale, G. Antonelli, M. Deschepper, M. Arvaniti, K. Blot, K. Brown, B.C. de Lange, D. De Waele, J. Dikmen, Y. Dimopoulos, G. Eckmann, C. Francois, G. Girardis, M. Koulenti, D. Labeau, S. Lipman, J. Lipovetsky, F. Maseda, E. Montravers, P. Mikstacki, A. Paiva, J.-A. Pereyra, C. Rello, J. Timsit, J.-F. Vogelaers, D. Blot, S. Lamrous, A. Lipovestky, F. Rezende-Neto, J. 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. Lipovestky, F. 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. 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. 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 and De Pascale, G. Antonelli, M. Deschepper, M. Arvaniti, K. Blot, K. Brown, B.C. de Lange, D. De Waele, J. Dikmen, Y. Dimopoulos, G. Eckmann, C. Francois, G. Girardis, M. Koulenti, D. Labeau, S. Lipman, J. Lipovetsky, F. Maseda, E. Montravers, P. Mikstacki, A. Paiva, J.-A. Pereyra, C. Rello, J. Timsit, J.-F. Vogelaers, D. Blot, S. Lamrous, A. Lipovestky, F. Rezende-Neto, J. 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. Lipovestky, F. 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. 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. 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

Abstract

Purpose: To describe data on epidemiology, microbiology, clinical characteristics and outcome of adult patients admitted in the intensive care unit (ICU) with secondary peritonitis, with special emphasis on antimicrobial therapy and source control. Methods: Post hoc analysis of a multicenter observational study (Abdominal Sepsis Study, AbSeS) including 2621 adult ICU patients with intra‐abdominal infection in 306 ICUs from 42 countries. Time-till-source control intervention was calculated as from time of diagnosis and classified into ‘emergency’ (< 2 h), ‘urgent’ (2–6 h), and ‘delayed’ (> 6 h). Relationships were assessed by logistic regression analysis and reported as odds ratios (OR) and 95% confidence interval (CI). Results: The cohort included 1077 cases of microbiologically confirmed secondary peritonitis. Mortality was 29.7%. The rate of appropriate empiric therapy showed no difference between survivors and non-survivors (66.4% vs. 61.3%, p = 0.1). A stepwise increase in mortality was observed with increasing Sequential Organ Failure Assessment (SOFA) scores (19.6% for a value ≤ 4–55.4% for a value > 12, p < 0.001). The highest odds of death were associated with septic shock (OR 3.08 [1.42–7.00]), late-onset hospital-acquired peritonitis (OR 1.71 [1.16–2.52]) and failed source control evidenced by persistent inflammation at day 7 (OR 5.71 [3.99–8.18]). Compared with ‘emergency’ source control intervention (< 2 h of diagnosis), ‘urgent’ source control was the only modifiable covariate associated with lower odds of mortality (OR 0.50 [0.34–0.73]). Conclusion: ‘Urgent’ and successful source control was associated with improved odds of survival. Appropriateness of empirical antimicrobial treatment did not significantly affect survival suggesting that source control is more determinative for outcome. © 2022, Springer-Verlag GmbH Germany, part of Springer Nature.

Published
2022

7. 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 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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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17. 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. 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. 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. 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. 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. 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. 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, 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. 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. Tomescu, D. 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. Jovanovic, B. 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, N. the Abdominal Sepsis Study (AbSeS) group on behalf of the Trials Group of the European Society of Intensive Care Medicine

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. © 2019, The Author(s).

Published
2019

19. 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. 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. 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. 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. Boduli and 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. 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. 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. Boduli

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 outco

Published
2019

21. Detection rate of prostate cancer using prostate specific antigen in patients presenting with lower urinary tract symptoms: A retrospective study

Author

Chavan P, Chavan S, Chavan N, and Trivedi V

Subjects
lcsh:R, Detection rate, lcsh:Medicine, lower urinary tract symptoms, prostate specific antigen, prostate cancer
Abstract

Background: Need for undertaking prostate biopsies for detection of prostate cancer is often decided on the basis of serum levels of prostate specific antigen (PSA). Aim: To evaluate the case detection rate of prostate cancer among patients presenting with lower urinary tract symptoms (LUTS) on the basis of PSA levels and to assess the scope of prostate biopsy in these patients. Setting and Design: A retrospective study from a tertiary care center. Materials and Methods: The clinical and histopathological data of 922 patients presenting with LUTS in the last five years was obtained from the medical record section. They had been screened for prostate cancer using PSA and /or digital rectal examination examination followed by confirmation with prostate biopsy. Statistical Analysis Used: Detection rate and receiver operating characteristic curve were performed using SPSS 16 and Medcalc softwares. Results: The detection rate of prostate cancer according to the PSA levels was 0.6%, 2.3%, 2.5%, 34.1% and 54.9% in the PSA range of 0-4, 4-10, 10-20, 20-50 and> 50 ng/ml, respectively. Maximum prostate cancer cases were detected beyond a PSA value of 20 ng/ml whereas no significant difference in the detection rate was observed in the PSA range of 0-4, 4-10 and 10-20 ng/ml. Conclusion: A low detection rate of prostate cancer observed in the PSA range of 4-20 ng/ml in LUTS patients indicates the need for use of higher cutoff values of PSA in such cases. Therefore we recommend a cutoff of 20 ng/ml of PSA for evaluation of detection rate of prostate cancer among patients presenting with LUTS.

Published
2009

23. Screening and management of preinvasive lesions of the cervix: Good clinical practice recommendations from the Federation of Obstetrics and Gynaecologic Societies of India (FOGSI).

Author

Bhatla, Neerja, Singhal, Seema, Saraiya, Usha, Srivastava, Shikha, Bhalerao, Sarita, Shamsunder, Saritha, Chavan, Niranjan, Basu, Partha, Purandare, CN, Agarwal, P, Arora, M, Bhatla, N, Basu, P, Bhalerao, S, Batra, S, Banerjee, D, Chavan, N, Dhorepatil, B, Gupta, B, and Gandhi, G

Subjects
PAPILLOMAVIRUS disease diagnosis, TUMOR prevention, ACETIC acid, COLPOSCOPY, CYTOLOGY, MEDICAL protocols, PROFESSIONAL associations, CERVIX uteri tumors, DISEASE management, EARLY detection of cancer
Abstract

In India, there are marked variations in resources for cervical cancer screening. For the first time, resource‐stratified screening guidelines have been developed that will be suitable for low middle‐income countries with similar diversities. The current article describes the process and outcomes of these resource stratified guidelines for screening and treatment of preinvasive lesions of cervix. Evidence from literature was collated and various guidelines were reviewed by an expert panel. Based on the level of evidence, guidelines were developed for screening by human papillomavirus (HPV) testing, cytology and visual inspection after application of acetic acid (VIA), and management of screen positive lesions in different resource settings. Expert opinion was used for certain country‐specific situations. The healthcare system was stratified into two resource settings – good or limited. The mode of screening and treatment for each was described. HPV testing is the preferred method for cervical cancer screening. VIA by trained providers is especially suitable for low resource settings until an affordable HPV test becomes available. Healthcare providers can choose the most appropriate screening and treatment modality. A single visit approach is encouraged and treatment may be offered based on colposcopy diagnosis ('see and treat') or even on the basis of HPV test or VIA results ('screen and treat'), if compliance cannot be ensured. The Federation of Obsterician and Gynaecologists of India Good Clinical Practice Recommendations (FOGSI) GCPR are appropriately designed for countries with varied resource situations to ensure an acceptable cervical cancer prevention strategy. [ABSTRACT FROM AUTHOR]

Published
2020
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28. An observational study of screening, diagnosis, and management of operable cases of cervical cancer in a tertiary institute.

Author

Chavan, N. N., Raj, N., and d'Souza, N.

Subjects
*CERVICAL cancer diagnosis, *TERTIARY care, *HISTOPATHOLOGY, *HYSTERECTOMY, *LYMPH nodes
Abstract

Background: One in every five women suffering from cervical cancer belongs to India. Objectives: In this study, an attempt has been made to screen for cervical cancer in all sexually active females attending Gynaecology Out Patient Department (OPD), segregate operable and inoperable cases, study varying operative management of diagnosed cases of cervical cancer, and study the outcome and complications of the same. Materials and Methods: This was a prospective study carried out in the Department of Obstetrics and Gynaecology in a tertiary care referral hospital in Mumbai amidst the largest urban slum in Asia, Dharavi from January 2011 to December 2016. A total number of 36,100 patients attended the Gynecology OPD during the study period. Being an observational study, only percentage calculations were used in this study. Results: Incidence of neoplasia in this cohort by Pap smear cytology was 0.48%, thus proving the sensitivity of Pap smear to be 84.57%. Most of patients with cervical cancer belonged to the age group 30-39 years (35.9%), lower socioeconomic class (78.18%), and were multiparous (66.36%). Most common presenting complaint was abnormal vaginal discharge (including bleeding) occurring in 87%. Most common histopathological type was squamous cell carcinoma (81.81%). Total abdominal hysterectomy was done in 12 patients (Stage 1a1), Type 2 hysterectomy with pelvic lymph node dissection was done in 16 patients (Stage 1a2, Stage 1b1), and Type 3 hysterectomy with pelvic lymph node dissection was done in 15 patients (Stage 1b2, Stage 2a). Conclusion: Women continue to be afflicted by a disease that is potentially preventable and treatable when detected early. Those who are lost to screening or who do not receive screening at all are most susceptible to the development of cervical cancer. [ABSTRACT FROM AUTHOR]

Published
2019
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31. A comparative study of nutrients and mineral composition of Carallia brachiata (Lour.) Merill.

Author

Patil, Priya D., Chavan, N. S., Patil, Priya D., and Chavan, N. S.

Abstract

The proximate composition and mineral constituents of Carallia brachiata leaf and fruit powder were evaluated for their nutritional values and mineral compositions by using standard techniques. In proximate analysis, ash, carbohydrate, proteins, fiber, fat, moisture, total energy content (dry basis) was assayed while mineral analysis were carried out by using atomic absorption spectrophotometer. The species showed variable results in proximate analysis of both the parts; however, the fruit of C. brachiata have revealed higher percentage of carbohydrate (65.74%) and energy values (310.25Kcal/100g). The leaf showed higher percentage of proteins (13.59%) and crude fibers (18.87%). From the results is clear that both the parts of C. brachiata are rich in micronutrients like Cu, Zn and Fe. The proximate and nutrient analysis of the species can help us to determine the health benefits achieved from their use in marginal communities.

Published
2015

32. Study of mechanical properties and high temperature oxidation behavior of a novel cold-spray Ni-20Cr coating on boiler steels

Author

Kaur, N., Kumar, M., Sharma, S. K., Kim, D. Y., Kumar, S., Chavan, N. M., Joshi, Shrikant V., Singh, N., Singh, H., Kaur, N., Kumar, M., Sharma, S. K., Kim, D. Y., Kumar, S., Chavan, N. M., Joshi, Shrikant V., Singh, N., and Singh, H.

Abstract

In the current investigation, high temperature oxidation behavior of a novel cold-spray Ni-20Cr nano-structured coating was studied. The nanocrystalline Ni-20Cr powder was synthesized by the investigators using ball milling, which was deposited on T22 and SA 516 steels by cold spraying. The crystallite size based upon Scherrer's formula for the developed coatings was found to be in nano-range for both the substrates. The accelerated oxidation testing was performed in a laboratory tube furnace at a temperature 900 degrees C under thermal cyclic conditions. Each cycle comprised heating for one hour at 900 degrees C followed by cooling for 20 min in ambient air. The kinetics of oxidation was established using weight change measurements for the bare and the coated steels. The oxidation products were characterized by X-ray Diffraction (XRD), Scanning Electron Microscopy/Energy Dispersive Spectroscopy (SEM/EDS) and X-ray mapping techniques. It was found from the results that the coating was successful in reducing the weight gain of SA213-T22 and SA 516-Grade 70 steel by 71% and 94%, respectively. This may be attributed to relatively denser structure, lower porosity and lower oxide content of the coating. Moreover, the developed nano-structured Ni-20Cr powder coating was found to perform better than its counterpart micron-sized Ni-20Cr powder coating, in terms of offering higher oxidation resistance and hardness. (C) 2014 Elsevier B.V. All rights reserved.

Published
2015

33. Development of nano-crystalline cold sprayed Ni-20Cr coatings for high temperature oxidation resistance

Author

Kumar, M., Singh, H., Singh, N., Hong, S. M., Choi, I. S., Suh, J. Y., Chavan, N. M., Kumar, S., Joshi, S. V., Kumar, M., Singh, H., Singh, N., Hong, S. M., Choi, I. S., Suh, J. Y., Chavan, N. M., Kumar, S., and Joshi, S. V.

Abstract

In the current investigation a pre-synthesized nano-crystalline Ni-20Cr powder was deposited by cold-spray technique on SA 516 steel. The powder was synthesized by ball milling approach. The nano-crystallinity of the developed coating was established by crystallite size measurements from XRD profile, which was further endorsed by TEM analysis. High-temperature oxidation behavior of uncoated and coated samples was studied under cyclic isothermal conditions at 900 degrees C for 50 cycles in a laboratory tube furnace. The oxidation rates for the bare and coated steel were evaluated in terms of weight gain data. Different characterization techniques, such as X-ray diffraction (XRD), scanning electron microscopy/energy dispersive spectroscopy (SEM/EDS), and transmission electron microscopy (TEM) analyses were utilized to characterize the oxide scale. The hardness and oxidation resistance of the steel increased after the application of coating. The reduction in oxidation rate of the base steel was 94%. Moreover, the developed nanostructured coating was observed to reduce weight gain by 64% in comparison with micron-sized Ni-20Cr cold spray coating thus offers a higher oxidation resistance. This may be attributed to relatively denser structure, lower porosity and lower oxide content of the nanostructured coating. (C) 2015 Elsevier B.V. All rights reserved.

Published
2015

38. Proximate analysis and mineral characterization of Barringtonia species

Author

Patil, Priya D., Chavan, N. S., Patil, Priya D., and Chavan, N. S.

Abstract

The study about material contained in Barringtonia seeds were conducted at the first time using the standard procedure of AOAC. For present work, two species of Barringtonia were selected viz., B. acutangula and B. racemosa . The proximate composition and mineral constituents of Barringtonia seeds were evaluated. The B. acutangula seeds contained ash 4.24%, crude protein 9.23%, crude lipids 0.68%, crude fibre13.54% and carbohydrates 66.17%. While in seeds of B. racemosa, ash 4.02%, crude protein 12.09%, crude lipids 0.75%, crude fibre15.18% and carbohydrates: 64.67% were observed. Both the species have a high energy value on dry basis. Comparing the mineral content with recommended dietary allowances (RDA), the results indicated that seeds of B. acutangula fruits could be a good supplement for some nutrients such as calcium, fibre and carbohydrates, whereas the B. racemosa seeds could be a good supplement for some nutrients such as fibre, potassium, zinc and carbohydrates. The seeds of Barringtonia could be promoted as a carbohydrate supplement. Hence, this piece of work acclaims the potential of Barringtonia species indicating its proximate and mineral composition.

Published
2014

39. Biocontrol potential of actinomycetes against Xanthomonas axonopodis pv. punicae , a causative agent for oily spot disease of pomegranate.

Author

Chavan, N. P., Pandey, R., Nawani, N., Nanda, R. K., Tandon, G. D., and Khetmalas, M. B.

Subjects
*BIOLOGICAL pest control agents, *ACTINOBACTERIA, *XANTHOMONAS, *POMEGRANATE, *STREPTOMYCES
Abstract

India is a largest producer of pomegranate with high export value. The cultivation is affected with the oily spot disease caused byXanthomonas axonopodis pv. punicaeinfection. The present study aims to control the disease with newer biocontrol methods. Thirty-six isolates ofX. axonopodiswere isolated from different varieties of infected pomegranates fruits from Maharashtra. Forty strains of actinomycete were also isolated from natural sources and screened for their antagonistic activity againstX. axonopodisisolates. Eight strains of actinomycete were screened out for their high antagonistic activity and were optimized for maximizing antibiotic production. The extracted compound from A5 strain exhibited maximum inhibitory activity against all the pathogenic isolates with a MIC in the range of 0.625 to 1.25 mg mL−1. It was identified asStreptomyces violaceusnigeby 16SrRNA gene sequencing (Accession number KP208943). The extracted compound belonged to aminoglycosides with a molecular formula C22H28N3O6determined by thin layer chromatography, high-performance liquid chromatography, gas chromatography-mass spectroscopy, nuclear magnetic resonance spectroscopy, fourier transform infrared spectroscopy and carbon hydrogen nitrogen ratio analysis. In vivo biocontrol studies with strain A5 and its extracted compound effectively prevented the growth 36Xanthomonasisolates inoculated on pomegranate fruits, illustrating its biocontrol potential against the oily spot disease of pomegranate. [ABSTRACT FROM AUTHOR]

Published
2016
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