Epidemiology and outcomes of source control procedures in critically ill patients with intra-abdominal infection

2019 ◽  
Vol 52 ◽  
pp. 258-264 ◽  
Author(s):  
Kirsten van de Groep ◽  
Tessa L. Verhoeff ◽  
Diana M. Verboom ◽  
Lieuwe D. Bos ◽  
Marcus J. Schultz ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Source Control ◽  
Abdominal Infection ◽  
Control Procedures ◽  
Intra Abdominal Infection

scholarly journals Protocol for the pBDG2 Study: Prospective Evaluation of 1.3-β-D-Glucan in the Peritoneal Fluid for the Diagnosis of Intra-Abdominal Candidiasis in Critically Ill Patients

2021 ◽  
Vol 12 (1) ◽  
pp. 196-203
Author(s):  
Emmanuel Novy ◽  
François-Xavier Laithier ◽  
Jeremie Riviere ◽  
Thomas Remen ◽  
Marie-Reine Losser ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Peritoneal Fluid ◽  
Primary Objective ◽  
Current Status ◽  
Control Group ◽  
Abdominal Infection ◽  
Increased Risk ◽  
Intra Abdominal Infection ◽  
Abdominal Candidiasis

Background: The delayed diagnosis of the presence of Candida in severe intra-abdominal infections exposes patients to an increased risk of mortality. The prevalence of intra-abdominal candidiasis (IAC) varies with the type of intra-abdominal infection, the underlying conditions and the presence of risk factors for Candida infection. This study aims to evaluate the interest of the measure of 1.3-β-D-glucan (BDG) in the peritoneal fluid for the early diagnosis of IAC. Methods and analysis: This is a prospective multicenter (n = 5) non-interventional study, focusing on all critically ill patients with an intra-abdominal infection requiring intra-abdominal surgery. The primary objective is to assess the diagnostic performance of the BDG measured in the peritoneal fluid for the early detection of IAC using the Candida culture as the gold standard. The secondary objective is to report the prevalence of IAC in the selected population. This study aims to enroll 200 patients within 48 months. By estimating the prevalence of IAC in the selected population at 30%, 50 patients with IAC (cases) are expected. These 50 IAC cases will be matched with 50 non-IAC patients (as a control group). The peritoneal BDG will be measured a posteriori in all of these 100 selected patients. This article presents the protocol and the current status of the study. Only the prevalence of IAC is reported as preliminary result.

Risk factors for acute kidney injury in critically ill patients with complicated intra-abdominal infection

2017 ◽  
Vol 38 ◽  
pp. 104-108 ◽  
Author(s):  
Alejandro Suarez-de-la-Rica ◽  
Víctor Anillo ◽  
Ana Montero ◽  
Carmen Hernandez-Gancedo ◽  
Araceli Lopez-Tofiño ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Abdominal Infection ◽  
Intra Abdominal Infection

Intra-abdominal sepsis in the critically ill

2016 ◽  
Author(s):  
Jeffrey D. Doyle ◽  
John C. Marshall
Keyword(s):  
Critically Ill ◽  
Anaerobic Bacteria ◽  
Abdominal Sepsis ◽  
Source Control ◽  
Successful Management ◽  
Abdominal Infection ◽  
Infectious Disease Specialists ◽  
Intra Abdominal Infection ◽  
Abdominal Infections ◽  
Prompt Diagnosis

Intra-abdominal infection encompasses a broad group of infections arising both within the peritoneal cavity and the retroperitoneum. The probable bacteriology reflects patterns of normal and pathological colonization of the gastrointestinal tract. Anaerobic bacteria are found in the distal small bowel and colon. The abdomen is the second most common site of infection leading to sepsis in critically-ill patients. Intra-abdominal infections can be complex to manage and require excellent collaboration between intensivists, diagnostic and interventional radiologists, surgeons, and sometimes gastroenterologists and infectious disease specialists. Prompt diagnosis, appropriate antimicrobial coverage and timely source control are the cornerstones of successful management. The spectrum of pathologic conditions responsible for intra-abdominal infection is broad, although some common biological features facilitate an understanding of their diagnosis and management.

scholarly journals Comparative Population Plasma and Tissue Pharmacokinetics of Micafungin in Critically Ill Patients with Severe Burn Injuries and Patients with Complicated Intra-Abdominal Infection

2016 ◽  
Vol 60 (10) ◽  
pp. 5914-5921 ◽  
Author(s):  
A. García-de-Lorenzo ◽  
S. Luque ◽  
S. Grau ◽  
A. Agrifoglio ◽  
L. Cachafeiro ◽  
...  
Keyword(s):  
Critically Ill ◽  
Body Surface ◽  
Candida Parapsilosis ◽  
Total Body Surface Area ◽  
Burn Patients ◽  
Content Type ◽  
Abdominal Infection ◽  
Area Burned ◽  
Total Body ◽  
Intra Abdominal Infection

ABSTRACTSeverely burned patients have altered drug pharmacokinetics (PKs), but it is unclear how different they are from those in other critically ill patient groups. The aim of the present study was to compare the population pharmacokinetics of micafungin in the plasma and burn eschar of severely burned patients with those of micafungin in the plasma and peritoneal fluid of postsurgical critically ill patients with intra-abdominal infection. Fifteen burn patients were compared with 10 patients with intra-abdominal infection; all patients were treated with 100 to 150 mg/day of micafungin. Micafungin concentrations in serial blood, peritoneal fluid, and burn tissue samples were determined and were subjected to a population pharmacokinetic analysis. The probability of target attainment was calculated using area under the concentration-time curve from 0 to 24 h/MIC cutoffs of 285 forCandida parapsilosisand 3,000 for non-parapsilosis Candidaspp. by Monte Carlo simulations. Twenty-five patients (18 males; median age, 50 years; age range, 38 to 67 years; median total body surface area burned, 50%; range of total body surface area burned, 35 to 65%) were included. A three-compartment model described the data, and only the rate constant for the drug distribution from the tissue fluid to the central compartment was statistically significantly different between the burn and intra-abdominal infection patients (0.47 ± 0.47 versus 0.15 ± 0.06 h−1, respectively;P< 0.05). Most patients would achieve plasma PK/pharmacodynamic (PD) targets of 90% for non-parapsilosis Candidaspp. andC. parapsilosiswith MICs of 0.008 and 0.064 mg/liter, respectively, for doses of 100 mg daily and 150 mg daily. The PKs of micafungin were not significantly different between burn patients and intra-abdominal infection patients. After the first dose, micafungin at 100 mg/day achieved the PK/PD targets in plasma for MIC values of ≤0.008 mg/liter and ≤0.064 mg/liter for non-parapsilosis Candidaspp. andCandida parapsilosisspecies, respectively.

Diagnosis of intra-abdominal infection in the critically ill patient

2001 ◽  
Vol 7 (2) ◽  
pp. 117-121 ◽  
Author(s):  
Heather L. Evans ◽  
Daniel P. Raymond ◽  
Shawn J. Pelletier ◽  
Traves D. Crabtree ◽  
Timothy L. Pruett ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patient ◽  
Abdominal Infection ◽  
Intra Abdominal Infection
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