Abdominal infections in the intensive care unit: characteristics, treatment and determinants of outcome
Identifieur interne : 001C71 ( Ncbi/Curation ); précédent : 001C70; suivant : 001C72Abdominal infections in the intensive care unit: characteristics, treatment and determinants of outcome
Auteurs : Jan De Waele [Belgique] ; Jeffrey Lipman ; Yasser Sakr [Allemagne] ; John C. Marshall [Canada] ; Philippe Vanhems [France] ; Casiano Barrera Groba ; Marc Leone [France] ; Jean-Louis Vincent [Belgique]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2014.
Abstract
Abdominal infections are frequent causes of sepsis and septic shock in the intensive care unit (ICU) and are associated with adverse outcomes. We analyzed the characteristics, treatments and outcome of ICU patients with abdominal infections using data extracted from a one-day point prevalence study, the Extended Prevalence of Infection in the ICU (EPIC) II.
EPIC II included 13,796 adult patients from 1,265 ICUs in 75 countries. Infection was defined using the International Sepsis Forum criteria. Microbiological analyses were performed locally. Participating ICUs provided patient follow-up until hospital discharge or for 60 days.
Of the 7,087 infected patients, 1,392 (19.6%) had an abdominal infection on the study day (60% male, mean age 62 ± 16 years, SAPS II score 39 ± 16, SOFA score 7.6 ± 4.6). Microbiological cultures were positive in 931 (67%) patients, most commonly Gram-negative bacteria (48.0%). Antibiotics were administered to 1366 (98.1%) patients. Patients who had been in the ICU for ≤2 days prior to the study day had more
The characteristics, microbiology and antibiotic treatment of abdominal infections in critically ill patients are diverse. Mortality in patients with isolated abdominal infections was higher than in those who had other infections.
The online version of this article (doi:10.1186/1471-2334-14-420) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/1471-2334-14-420
PubMed: 25074742
PubMed Central: 4122779
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Jeffrey Lipman<affiliation><nlm:aff id="Aff2">Department of Intensive Care Medicine, Royal Brisbane and Women’s Hospital, The University of Queensland, Butterfield St, Herston, QLD 4029 Australia</nlm:aff>
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</affiliation>
<affiliation><nlm:aff id="Aff6">Department of Intensive Care, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Eastern Road, East Sussex, Brighton BN2 5BE UK</nlm:aff>
<wicri:noCountry code="subfield">Brighton BN2 5BE UK</wicri:noCountry>
</affiliation>
Le document en format XML
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<author><name sortKey="Vincent, Jean Louis" sort="Vincent, Jean Louis" uniqKey="Vincent J" first="Jean-Louis" last="Vincent">Jean-Louis Vincent</name>
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<series><title level="j">BMC Infectious Diseases</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Abdominal infections are frequent causes of sepsis and septic shock in the intensive care unit (ICU) and are associated with adverse outcomes. We analyzed the characteristics, treatments and outcome of ICU patients with abdominal infections using data extracted from a one-day point prevalence study, the Extended Prevalence of Infection in the ICU (EPIC) II.</p>
</sec>
<sec><title>Methods</title>
<p>EPIC II included 13,796 adult patients from 1,265 ICUs in 75 countries. Infection was defined using the International Sepsis Forum criteria. Microbiological analyses were performed locally. Participating ICUs provided patient follow-up until hospital discharge or for 60 days.</p>
</sec>
<sec><title>Results</title>
<p>Of the 7,087 infected patients, 1,392 (19.6%) had an abdominal infection on the study day (60% male, mean age 62 ± 16 years, SAPS II score 39 ± 16, SOFA score 7.6 ± 4.6). Microbiological cultures were positive in 931 (67%) patients, most commonly Gram-negative bacteria (48.0%). Antibiotics were administered to 1366 (98.1%) patients. Patients who had been in the ICU for ≤2 days prior to the study day had more <italic>Escherichia coli</italic>
, methicillin-sensitive <italic>Staphylococcus aureus</italic>
and anaerobic isolates, and fewer enterococci than patients who had been in the ICU longer<italic>.</italic>
ICU and hospital mortality rates were 29.4% and 36.3%, respectively. ICU mortality was higher in patients with abdominal infections than in those with other infections (29.4% vs. 24.4%, p < 0.001). In multivariable analysis, hematological malignancy, mechanical ventilation, cirrhosis, need for renal replacement therapy and SAPS II score were independently associated with increased mortality.</p>
</sec>
<sec><title>Conclusions</title>
<p>The characteristics, microbiology and antibiotic treatment of abdominal infections in critically ill patients are diverse. Mortality in patients with isolated abdominal infections was higher than in those who had other infections.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/1471-2334-14-420) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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