Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project

Collapse authors list.
Blot, S ORCID: 0000-0003-2145-0345, Antonelli, M, Arvaniti, K, Blot, K, Creagh-Brown, B, de Lange, D, De Waele, J, Deschepper, M, Dikmen, Y, Dimopoulos, G et al (show 86 more authors) , Eckmann, C, Francois, G, Girardis, M, Koulenti, D, Labeau, S, Lipman, J, Lipovestky, F, Maseda, E, Montravers, P, Mikstacki, A, Paiva, JA, Pereyra, C, Rello, J, Timsit, JF, Vogelaers, D, Lamrous, A, Rezende-Neto, J, Cardenas, Y, Vymazal, T, Fjeldsoee-Nielsen, H, Kott, M, Kostoula, A, Javeri, Y, Einav, S, Makikado, LDU, Tomescu, D, Gritsan, A, Jovanovic, B, Venkatesan, K, Mirkovic, T, Emmerich, M, Canale, M, Dietz, LS, Ilutovich, S, Miñope, JTS, Silva, RB, Montenegro, MA, Martin, P, Saul, P, Chediack, V, Sutton, G, Couce, R, Balasini, C, Gonzalez, S, Lascar, FM, Descotte, EJ, Gumiela, NS, Pino, CA, Cesio, C, Valgolio, E, Cunto, E, Dominguez, C, Nelson, NF, Abegao, EM, Pozo, NC, Bianchi, L, Correger, E, Pastorino, ML, Miyazaki, EA, Grubissich, N, Garcia, M, Bonetto, N, Quevedo, NE, Gomez, CD, Queti, F, Estevarena, LG, Fernandez, R, Santolaya, I, Grangeat, SH, Doglia, J, Zakalik, G, Pellegrini, C, Lloria, MM, Chacon, ME, Fumale, M, Leguizamon, M, Hidalgo, IB, Tiranti, RJ, Capponi, P, Tita, A, Cardonnet, L, Bettini, L, Ramos, A, Lovesio, L, Miranda, EM and Farfan, AB (2019) Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project Intensive Care Medicine, 45 (12). pp. 1703-1717. ISSN 0342-4642, 1432-1238

Access the full-text of this item by clicking on the Open Access link.

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.

Item Type:	Article
Uncontrolled Keywords:	Intra-abdominal infection, Peritonitis, Sepsis, Intensive care, Multidrug resistance, Mortality
Depositing User:	Symplectic Admin
Date Deposited:	07 Feb 2020 11:23
Last Modified:	01 Mar 2026 10:53
DOI:	10.1007/s00134-019-05819-3
Open Access URL:	https://doi.org/10.1007/s00134-019-05819-3
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3073951
Disclaimer:	The University of Liverpool is not responsible for content contained on other websites from links within repository metadata. Please contact us if you notice anything that appears incorrect or inappropriate.