scholarly journals Outcome of Community- versus Hospital-Acquired Intra-Abdominal Infections in Intensive Care Unit: a Retrospective Study

2020 ◽  
Author(s):  
Timothée Abaziou ◽  
Fanny Vardon-Bounes ◽  
Jean-Marie Conil ◽  
Antoine Rouget ◽  
Stéphanie Ruiz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Apache Ii Score ◽  
Abdominal Infection ◽  
Hospital Stays ◽  
Intra Abdominal Infection ◽  
Abdominal Infections ◽  
Hospital Acquired

Abstract Background: To compare patients hospitalised in the intensive care unit (ICU) after surgery for community-acquired intra-abdominal infection (CA-IAI) and hospital-acquired intra-abdominal infection (HA-IAI) in terms of mortality, severity and complications.Methods: Retrospective study including all patients admitted to 2 ICUs within 48 hours of undergoing surgery for peritonitis.Results: 226 patients were enrolled during the study period. Patients with CA-IAI had an increased 28-day mortality rate compared to those with HA-IAI (30% vs 15%, respectively (p = 0.009)). At 90 days, the mortality rates were 36.7% and 37.5% in the CA-IAI group and HA-IAI group, respectively, with a similar APACHE II score on admission (median: 21 [15 – 25] vs. 21 [15 - 24] respectively, p = 0.63). The patients with HA-IAI had prolonged ICU and hospital stays (median: 17 [7 – 36] vs. 6[3 – 12] days, p < 0.001 and 41 [24 – 66] vs. 17 [7 – 32] days, p = 0.001), and experienced more complications (reoperation and reintubation) than those with CA-IAI.Conclusion: CA-IAI group had higher 28-day mortality rate than HA-IAI group. Mortality was similar at 90 days but those with HA-IAI had a prolonged ICU and hospital stay. In addition, they developed more complications.

scholarly journals Outcome of Community- versus Hospital-Acquired Intra-Abdominal Infections in Intensive Care Unit: a Retrospective Study

2020 ◽  
Author(s):  
Timothée Abaziou ◽  
Fanny Vardon-Bounes ◽  
Jean-Marie Conil ◽  
Antoine Rouget ◽  
Stéphanie Ruiz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Apache Ii Score ◽  
Abdominal Infection ◽  
Hospital Stays ◽  
Intra Abdominal Infection ◽  
Abdominal Infections ◽  
Hospital Acquired

Abstract Background: To compare patients hospitalised in the intensive care unit (ICU) after surgery for community-acquired intra-abdominal infection (CA-IAI) and hospital-acquired intra-abdominal infection (HA-IAI) in terms of mortality, severity and complications.Methods: Retrospective study including all patients admitted to 2 ICUs within 48 hours of undergoing surgery for peritonitis.Results: 226 patients were enrolled during the study period. Patients with CA-IAI had an increased 28-day mortality rate compared to those with HA-IAI (30% vs 15%, respectively (p = 0.009)). At 90 days, the mortality rates were 36.7% and 37.5% in the CA-IAI group and HA-IAI group, respectively, with a similar APACHE II score on admission (median: 21 [15 – 25] vs. 21 [15 - 24] respectively, p = 0.63). The patients with HA-IAI had prolonged ICU and hospital stays (median: 17 [7 – 36] vs. 6[3 – 12] days, p < 0.001 and 41 [24 – 66] vs. 17 [7 – 32] days, p = 0.001), and experienced more complications (reoperation and reintubation) than those with CA-IAI. Conclusion: CA-IAI group had higher 28-day mortality rate than HA IAI group. Mortality was similar at 90 days but those with HA-IAI had a prolonged ICU and hospital stay. In addition, they developed more complications.

scholarly journals Outcome of community- versus hospital-acquired intra-abdominal infections in intensive care unit: a retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Timothée Abaziou ◽  
Fanny Vardon-Bounes ◽  
Jean-Marie Conil ◽  
Antoine Rouget ◽  
Stéphanie Ruiz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Apache Ii Score ◽  
Abdominal Infection ◽  
Hospital Stays ◽  
Intra Abdominal Infection ◽  
Abdominal Infections ◽  
Hospital Acquired

Abstract Background To compare patients hospitalised in the intensive care unit (ICU) after surgery for community-acquired intra-abdominal infection (CA-IAI) and hospital-acquired intra-abdominal infection (HA-IAI) in terms of mortality, severity and complications. Methods Retrospective study including all patients admitted to 2 ICUs within 48 h of undergoing surgery for peritonitis. Results Two hundred twenty-six patients were enrolled during the study period. Patients with CA-IAI had an increased 28-day mortality rate compared to those with HA-IAI (30% vs 15%, respectively (p = 0.009)). At 90 days, the mortality rates were 36.7 and 37.5% in the CA-IAI group and HA-IAI group, respectively, with a similar APACHE II score on admission (median: 21 [15–25] vs. 21 [15–24] respectively, p = 0.63). The patients with HA-IAI had prolonged ICU and hospital stays (median: 17 [7–36] vs. 6[3–12] days, p < 0.001 and 41 [24–66] vs. 17 [7–32] days, p = 0.001), and experienced more complications (reoperation and reintubation) than those with CA-IAI. Conclusion CA-IAI group had higher 28-day mortality rate than HA-IAI group. Mortality was similar at 90 days but those with HA-IAI had a prolonged ICU and hospital stay. In addition, they developed more complications.

scholarly journals Outcome of Community- Versus Hospital-Acquired Intra-Abdominal Infections in Intensive Care Unit: a Retrospective Study

2020 ◽  
Author(s):  
Timothée Abaziou ◽  
Fanny Vardon-Bounes ◽  
Jean-Marie Conil ◽  
Antoine Rouget ◽  
Stéphanie Ruiz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Mortality Rates ◽  
Apache Ii Score ◽  
Abdominal Infection ◽  
Hospital Stays ◽  
Intra Abdominal Infection ◽  
Abdominal Infections ◽  
Hospital Acquired

Abstract BackgroundTo compare patients hospitalised in the intensive care unit (ICU) after surgery for community-acquired intra-abdominal infection (CA-IAI) and hospital-acquired intra-abdominal infection (HA-IAI) in terms of mortality, severity and complications.MethodsRetrospective study including all patients admitted to 2 ICUs within 48 hours of undergoing surgery for peritonitis.Results226 patients were enrolled during the study period. Patients with CA-IAI had an increased 28-day mortality rate compared to those with HA-IAI (30% vs 15%, respectively (p = 0.009)). At 90 days, the mortality rates were 36.7% and 37.5% in the CA-IAI group and HA_IAI group, respectively, with a similar APACHE II score on admission (median: 21 [15–25] vs. 21 [15–24] respectively, p = 0.63). The patients with HA-IAI had prolonged ICU and hospital stays (median: 17 [7–36] vs. 6[3–12] days, p < 0.001 and 41 [24–66] vs. 17 [7–32] days, p = 0.001), and experienced more complications (reoperation and reintubation) than those with CAP.ConclusionCA-IAI group had higher 28-day mortality rate than HA IAI group. Mortality was similar at 90 days but those with HAP had a prolonged ICU and hospital stay. In addition, they developed more complications.

scholarly journals Hospital-Acquired Blood Stream Infection in an Adult Intensive Care Unit

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jeffrey Harte ◽  
Germander Soothill ◽  
John Glynn David Samuel ◽  
Laurence Sharifi ◽  
Mary White
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Blood Stream Infection ◽  
Case Series ◽  
Blood Stream ◽  
Apache Ii Score ◽  
Invasive Procedures ◽  
Adult Intensive Care Unit ◽  
Hospital Acquired

Background. Hospital-acquired blood stream infections are a common and serious complication in critically ill patients. Methods. A retrospective case series was undertaken investigating the incidence and causes of bacteraemia in an adult intensive care unit with a high proportion of postoperative cardiothoracic surgical and oncology patients. Results. 405 eligible patients were admitted to the intensive care unit over the course of nine months. 12 of these patients developed a unit-acquired blood stream infection. The average Acute Physiology And Chronic Health Evaluation II (APACHE II) score of patients who developed bacteraemia was greater than that of those who did not (19.8 versus 16.8, respectively). The risk of developing bacteraemia was associated with intubation and higher rates of invasive procedures. The mortality rate amongst the group of patients that developed bacteraemia was 33%; this is in contrast to the mortality rate in our unit as 27.2%. There was a higher proportion of Gram-negative bacteria isolated on blood cultures (9 out of 13 isolates) than in intensive care units reported in other studies. Conclusion. Critical-care patients are at risk of secondary bloodstream infection. This study highlights the importance of measures to reduce the risk of infection in the intensive-care setting, particularly in patients who have undergone invasive procedures.

Outcomes of Critically Ill Gynecological Cancer Patients Admitted to Intensive Care Unit

2012 ◽  
Vol 30 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Silvio A. Ñamendys-Silva ◽  
María O. González-Herrera ◽  
Julia Texcocano-Becerra ◽  
Angel Herrera-Gómez
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Gynecological Cancer ◽  
Apache Ii ◽  
Apache Ii Score

Purpose: To assess the characteristics of critically ill patients with gynecological cancer, and to evaluate their prognosis. Methods: Fifty-two critically ill patients with gynecological cancer admitted to intensive care unit (ICU) were included. Univariate and multivariate logistic regressions were used to identify factors associated with hospital mortality. Results: Thirty-five patients (67.3%) had carcinoma of the cervix uteri and 11 (21.2%) had ovarian cancer. The mortality rate in the ICU was 17.3% (9 of 52) and hospital mortality rate were 23%(12 of 52). In the multivariate analysis, independent prognostic factors for hospital mortality were vasopressor use (odds ratio [OR] = 8.60, 95% confidence interval [CI] 2.05-36; P = .03) and the Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR = 1.43, 95% CI 1.01-2.09; P = .048). Conclusions: The independent prognostic factors for hospital mortality were the need for vasopressors and the APACHE II score.

scholarly journals Antibiotic susceptibility of intra-abdominal infection isolates from Indian hospitals during 2008

2010 ◽  
Vol 59 (9) ◽  
pp. 1050-1054 ◽  
Author(s):  
Stephen P. Hawser ◽  
Robert E. Badal ◽  
Samuel K. Bouchillon ◽  
Daryl J. Hoban ◽  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Antimicrobial Resistance ◽  
Gram Negative ◽  
E Coli ◽  
Abdominal Infection ◽  
Intra Abdominal Infection ◽  
Abdominal Infections ◽  
Hospital Acquired ◽  
Very High

A total of 542 clinical isolates of aerobic Gram-negative bacilli from intra-abdominal infections were collected during 2008 from seven hospitals in India participating in the Study for Monitoring Antimicrobial Resistance Trends (SMART). Isolates were from various infection sources, the most common being gall bladder (30.1 %) and peritoneal fluid (31.5 %), and were mostly hospital-associated isolates (70.8 %) as compared to community-acquired (26.9 %). The most frequently isolated pathogens were Escherichia coli (62.7 %), Klebsiella pneumoniae (16.7 %) and Pseudomonas aeruginosa (5.3 %). Extended-spectrum β-lactamase (ESBL) rates in E. coli and K. pneumoniae were very high, at 67 % and 55 %, respectively. Most isolates exhibited resistance to one or more antibiotics. The most active drugs were generally ertapenem, imipenem and amikacin. However, hospital-acquired isolates in general, as well as ESBL-positive isolates, exhibited lower susceptibilities than community-acquired isolates. Further surveillance monitoring of intra-abdominal isolates from India is recommended.

scholarly journals Influence of time elapsed from end of emergency surgery until admission to intensive care unit, on Acute Physiology and Chronic Health Evaluation II (APACHE II) prediction and patient mortality rate

2005 ◽  
Vol 123 (4) ◽  
pp. 167-174 ◽  
Author(s):  
Paulo Antonio Chiavone ◽  
Samir Rasslan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Emergency Surgery ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Death Risk ◽  
Expected Mortality

CONTEXT AND OBJECTIVE: Patients are often admitted to intensive care units with delay in relation to when this service was indicated. The objective was to verify whether this delay influences hospital mortality, length of stay in the unit and hospital, and APACHE II prediction. DESIGN AND SETTING: Prospective and accuracy study, in intensive care unit of Santa Casa de São Paulo, a tertiary university hospital. METHODS: We evaluated all 94 patients admitted following emergency surgery, from August 2002 to July 2003. The variables studied were APACHE II, death risk, length of stay in the unit and hospital, and hospital mortality rate. The patients were divided into two groups according to the time elapsed between end of surgery and admission to the unit: up to 12 hours and over 12 hours. RESULTS: The groups were similar regarding gender, age, diagnosis, APACHE II score and hospital stay. The death risk factors were age, APACHE II and elapsed time (p < 0.02). The mortality rate for the over 12-hour group was higher (54% versus 26.1%; p = 0.018). For the over 12-hour group, observed mortality was higher than expected mortality (p = 0.015). For the up to 12-hour group, observed and expected mortality were similar (p = 0.288). CONCLUSION: APACHE II foresaw the mortality rate among patients that arrived faster to the intensive care unit, while the mortality rate was higher among those patients whose admission to the intensive care unit took longer.

scholarly journals Efficacy of Phenobarbital in Neonatal Seizures

1985 ◽  
Vol 12 (2) ◽  
pp. 95-99 ◽  
Author(s):  
C.B. Van Orman ◽  
H.Z. Darwish
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Loading Dose ◽  
Neonatal Seizures ◽  
Clonic Seizures ◽  
Poor Efficacy

ABSTRACT:A retrospective study of neonatal seizures in a tertiary care neonatal intensive care unit determined a 3.2% incidence, and confirmed the relatively poor efficacy of the traditional anticonvulsants phenobarbital and phenytoin. Only 33% responded to an initial adequate loading dose of phenobarbital, while 56% responded to either or both anticonvulsants. Although multifocal clonic seizures were most common (42%), tonic seizures were next in freqency (30%). Tonic seizures which did not respond to phenobarbital responded quite poorly to the addition of phenytoin compared to other seizure types. Tonic seizures may be the result of brainstem release phenomena and require a different strategy for management. Among nonresponders in this study, there was a 56% mortality rate but only 33% of responders died. There is a critical need for studies to find more efficacious agents than phenobarbital and phenytoin to treat seizures in the newborn.

scholarly journals Epidemiology, clinical relevance and prognosis of staphylococci in hospital-acquired postoperative intra-abdominal infections: an observational study in intensive care unit

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kévin Boussion ◽  
Nathalie Zappella ◽  
Nathalie Grall ◽  
Lara Ribeiro-Parenti ◽  
Grégory Papin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Outcomes ◽  
Clinical Characteristics ◽  
Tertiary Care ◽  
University Hospital ◽  
Coagulase Negative Staphylococci ◽  
One Year ◽  
Abdominal Infections ◽  
Hospital Acquired

AbstractThe pathogenic role of staphylococci in hospital-acquired postoperative intra-abdominal infections (HAIs) has never been evaluated. In a tertiary care university hospital, we assessed the clinical characteristics and outcomes of patients admitted to the intensive care unit for HAIs according to the presence of staphylococci (S-HAI) or their absence (nS-HAI) in peritoneal cultures. Patients with S-HAIs were compared to nS-HAIs patients. Overall, 380 patients were analyzed, including 87 (23%) S-HAI patients [29 Staphylococcus aureus (Sa-HAIs) and 58 coagulase-negative staphylococci (CoNS-HAIs)]. The clinical characteristics did not differ between the S-HAI and nS-HAI patients. Adequacy of empirical anti-infective therapy was achieved less frequently in the staphylococci group (54 vs 72%, respectively, p < 0.01). The 90-day (primary endpoint) and one-year mortality rates did not differ between these groups. The S-HAI patients had decreased rates of postoperative complication (p < 0.05). The adjusted analysis of the clinical outcomes reported a decreased frequency of surgical complications in the staphylococci group (OR 0.43, 95% CI [0.20–0.93], p = 0.03). While the trends toward decreased morbidity criteria were observed in S-HAI patients, the clinical outcomes were not different between the CoNS-HAI and Sa-HAI patients. In summary, our data are not substantial enough to conclude that staphylococci exhibit no pathogenicity in HAIs.

scholarly journals Hospital-Acquired Pneumonia in a Multipurpose Intensive Care Unit: One-Year Prospective Study

2019 ◽  
Vol 32 (12) ◽  
pp. 746
Author(s):  
Rui Dias Costa ◽  
João Pedro Baptista ◽  
Ricardo Freitas ◽  
Paulo Jorge Martins
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Intensive Care Unit Mortality ◽  
Bacterial Flora ◽  
Multidrug Resistant ◽  
Multidrug Resistant Organisms ◽  
Hospital Acquired Pneumonia ◽  
One Year ◽  
Hospital Acquired

Introduction: Hospital-acquired pneumonia continues to be a frequent complication in the intensive care unit and an important cause of admission in the intensive care unit. The aim of our study was to evaluate the demography, incidence, risk factors, causative bacterial pathogens and outcome of all episodes of Hospital-acquired pneumonia in our unit.Material and Methods: Prospective observational study, at a tertiary university hospital during one year (2014) including all the cases of hospital-acquired pneumonia in the intensive care unit.Results: Sixty patients were identified with pneumonia. Thirty-five (58.3%) had an intensive care unit acquired pneumonia, corresponding to 6.9 cases/1000 intubation-days. Antibiotic treatment in the previous 30 days was present in 75% of the cases. The incidence of Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii was 26.2%, 20.0% and 9.2%, respectively. Patients with late-onset hospital-acquired pneumonia (≥ 7 days) showed higher frequency of non-fermenting Gram-negative bacilli isolates, and methicillin-resistant S. aureus. Combination therapy was performed in 67.0%, and de-escalation in 18.3%. The mortality rate was 18.3%. The adjusted odds ratio for intensive care unit mortality in the group of patients with non-intensive care unit acquired pneumonia was 5.2 (95% CI of 1.02 – 22.10; p = 0.046).Discussion: The knowledge of local bacterial flora and resistance patterns is of crucial importance and strongly recommended. This evidence increases the probability of success of empiric antibiotic therapy.Conclusion: S. aureus was the predominant causative agent of nosocomial pneumonia. The most frequent risk factor identified for infection with multidrug-resistant organisms was previous treatment with antibiotics. Multidrug-resistant organisms were present in 45% of documented hospital-acquired pneumonias. In admitted patients with non-intensive care unit acquired pneumonia, the intensive care unit mortality rate was nearly five times higher compared to intensive care unit acquired pneumonia.

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