scholarly journals Predictors of relaparotomy for persisting intra abdominal infection in secondary peritonitis

2021 ◽  
Vol 5 (3) ◽  
pp. 35-42
Author(s):  
Abel Tesfaye ◽  
◽  
Henock T/Selase ◽  
Keyword(s):  
Secondary Peritonitis ◽  
Intraabdominal Infection ◽  
High Morbidity ◽  
Clinical Model ◽  
Abdominal Infection ◽  
Clinical Variables ◽  
Medical College ◽  
Referral Hospitals ◽  
Intra Abdominal Infection ◽  
Planned Relaparotomy

Background: Peritonitis is one of the commonest causes of acute abdomen in Ethiopia. One of the causes of high morbidity and mortality is persistent intraabdominal infection. The two essential approaches for managing post-op collection are laparotomy on-demand and planned Relaparotomy. Despite multiple studies, both have comparative mortality. This study aimed to identify clinical variables that are predictive of persistent intraabdominal infection. Methods: A retrospective study was conducted on patients who were operated on from Sept 2018 to April 2020 at two affiliated referral hospitals of AAU, college of Medicine; Yekatit 12 hospital Medical College and Minilik II referral Hospital. All of the patients were cases of secondary peritonitis. Clinical progress of the patients from admission to discharge/death was documented. Multiple preoperative and intraoperative variables were analyzed to develop the predictive clinical model. Results: Out of 172 laparotomy cases for secondary peritonitis, 40 (23.3%) required relaparotomy for postop collection. From Patients who developed postop collection, 45% of them were diagnosed after pus/Gi content leaked through the surgical wound. The mortality rate of patients who develop postop collection and undergone relaparotomy was 27.5 % and 4.5% for those without postop collection. Logistic regression identified 4 variables as having significant predictive value: Duration of illness more than 5 days, Systolic BP 1000 ml, and small bowel as a source of contamination. Overall prediction successes of the above model is 88.4% (sensitivity 53.3%, specificity 96.8%). Conclusion: Management of persistent intra-abdominal infection is challenging. We have identified 4 clinical variables that predict persistent intraabdominal infection requiring relaparotomy. These sets of variables can be a milestone for future validation study before being inserted in today to day clinical practice.

An Open-Label, Multicenter, Observational Study of The Effectiveness of The Cefepime/Sulbactam Antibiotic (Maxictam®-AF) In Patients With Intra Abdominal Infection, Nosocomial Pneumonia or Ventilator-Associated Pneumonia (Study MAXI-2019)

2021 ◽  
Vol 65 (11-12) ◽  
pp. 49-58
Author(s):  
S. V. Yakovlev ◽  
M. P. Suvorova ◽  
A. O. Bykov ◽  
S. V. Zhuravel ◽  
K. A. Popugaev ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Observational Study ◽  
Nosocomial Pneumonia ◽  
Intraabdominal Infection ◽  
Apache Ii ◽  
Ventilator Associated Pneumonia ◽  
Open Label ◽  
Multicenter Observational Study ◽  
Abdominal Infection ◽  
Intra Abdominal Infection

The aim of the study was to evaluate the effectiveness of cefepime/sulbactam in patients with intra-abdominal infection, nosocomial pneumonia (NP) or ventilator-associated pneumonia (VAP) in actual clinical practice. Material and methods. The study was conducted in 14 Russian Clinics from October 2019 to March 2020. Study design: an open-label, prospective, non-comparative, multicenter, observational study. The study included patients who met the inclusion/exclusion criteria and signed a written informed consent. The studied antibiotic: cefepime/sulbactam (Maxictam®-AF). The primary parameter for effectiveness evaluation was the clinical effect after the conclusion of cefepime/sulbactam therapy — recovery/improvement or no effect. Results. The study included 140 patients (average age — 60.8 years) who received at least one dose of cefepime/sulbactam; 37 of them had intraabdominal infection, 72 — NP, and 31 — VAP. Most of the included patients were in the ICU department (82.1%) and their condition was severe: the average APACHE II score was 15.5 points, SOFA — 5.4 points, the Mannheim peritonitis index value in patients with intra-abdominal infection was from 14 to 35 points, with an average of 24.3 points. The majority of patients treated with cefepime/sulbactam (68.6%) had one or more risk factors for multi-resistant pathogens upon hospital or ICU admission. Cefepime/sulbactam was prescribed as the 1st or 2nd line of empirical therapy at a daily dose of 4 g (in 68.3%), 6 g (2.9%) or 8 g (28.8%); most patients were prescribed cefepime/sulbactam in monotherapy (72.3%). The average duration of therapy with cefepime/sulbactam was 9.6±3.5 days. The final assessment of treatment effectiveness was carried out in 132 patients: recovery or improvement was noted in 80.6% of patients with intra-abdominal infection, the effectiveness in NP and VAP was slightly higher — 95.6 and 89.3%. The effect was absent in 5.3% of patients, relapse or superinfection was noted in 3.0 and 1.5%. The majority of patients (81.3%) treated with cefepime/sulbactam were discharged from the hospital. No serious side effects were observed. In patients with a positive effect, age and values of APACHE II were significantly lower (59.58 years and 14.79 points) compared to those with no effect (67.95 years and 18.39 points). A multivariate analysis found that the probability of recovery of patients treated with cefepime/sulbactam did not depend on the diagnosis of infection, ICU admission, the presence of sepsis or septic shock. Conclusion. The multicenter study has established a high clinical efficacy of cefepime/sulbactam in real clinical practice in the treatment of patients with severe intraabdominal infection, nosocomial pneumonia or ventilator-associated pneumonia.

scholarly journals Elizabethkingia Intra-Abdominal Infection and Related Trimethoprim-Sulfamethoxazole Resistance: A Clinical-Genomic Study

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 173 ◽  
Author(s):  
Ling-Chiao Teng ◽  
Jiunn-Min Wang ◽  
Hsueh-Yin Lu ◽  
Yan-Chiao Mao ◽  
Kuo-Lung Lai ◽  
...  
Keyword(s):  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Successful Treatment ◽  
High Morbidity ◽  
Whole Genome ◽  
Indwelling Catheter ◽  
Abdominal Infection ◽  
Genomic Study ◽  
Intra Abdominal Infection ◽  
Tract Infections

(1) Background: Elizabethkingia spp. is an emerging nosocomial pathogen which causes mostly blood stream infection and nosocomial pneumonia. Among Elizabethkingia species, Elizabethkingia anophelis is the major pathogen, but misidentification as Elizabethkingia meningoseptica is a common problem. Elizabethkingia also possesses broad antibiotic resistance, resulting in high morbidity and mortality of the infection. The aim of our study was to review Elizabethkingia intra-abdominal infections and investigate resistance mechanisms against TMP/SMX in Elizabethkingia anophelis by whole genome sequencing. (2) Methods: We retrospectively searched records of patients with Elizabethkingia intra-abdominal infection between 1990 and 2019. We also conducted whole genome sequencing for a TMP/SMX-resistant Elizabethkingia anophelis to identify possible mechanisms of resistance. (3) Results: We identified a total of nine cases of Elizabethkingia intra-abdominal infection in a review of the literature, including our own case. The cases included three biliary tract infections, three CAPD-related infection, two with infected ascites, and two postoperation infections. Host factor, indwelling-catheter, and previous invasive procedure, including surgery, play important roles in Elizabethkingia infection. Removal of the catheter is crucial for successful treatment. Genomic analysis revealed accumulated mutations leading to TMP/SMX-resistance in folP. (4) Conclusions: Patients with underlying disease and indwelling catheter are more susceptible to Elizabethkingia intra-abdominal infection, and successful treatment requires removal of the catheter. The emerging resistance to TMP/SMX may be related to accumulated mutations in folP.

scholarly journals 4CPS-250 Evaluation of prescription adequacy to the antibiotherapy protocol in intra-abdominal infection in a regional hospital

2021 ◽  
Author(s):  
C Aguilar Guisado ◽  
S Sanchez Suarez ◽  
MI Barcia Martin ◽  
L Aguilar Garcia ◽  
M Garcia Gimeno
Keyword(s):  
Regional Hospital ◽  
Abdominal Infection ◽  
Intra Abdominal Infection

scholarly journals Prediction of Pharmacokinetics and Penetration of Moxifloxacin in Human with Intra-Abdominal Infection Based on Extrapolated PBPK Model

2015 ◽  
Vol 19 (2) ◽  
pp. 99 ◽  
Author(s):  
LiQin Zhu ◽  
JianWei Yang ◽  
Yuan Zhang ◽  
YongMing Wang ◽  
JianLei Zhang ◽  
...  
Keyword(s):  
Pbpk Model ◽  
Abdominal Infection ◽  
Intra Abdominal Infection

Postoperative intra-abdominal infection increases angiogenesis and tumor recurrence after surgical excision of colon cancer in mice

Surgery ◽  
2010 ◽  
Vol 147 (1) ◽  
pp. 120-126 ◽  
Author(s):  
Bernhard Bohle ◽  
Miguel Pera ◽  
Marta Pascual ◽  
Sandra Alonso ◽  
Xavier Mayol ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Tumor Recurrence ◽  
Surgical Excision ◽  
Abdominal Infection ◽  
Intra Abdominal Infection

scholarly journals Management of Nonunion of Tibia by Ilizarov Technique

2013 ◽  
Vol 2 (2) ◽  
pp. 41-45
Author(s):  
MA Haque ◽  
SM Islam ◽  
MR Chowdhury
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Limb Length Discrepancy ◽  
High Morbidity ◽  
Infected Nonunion ◽  
College Hospital ◽  
Medical College ◽  
Vehicle Accident ◽  
Fall From Height ◽  
Initial Procedure

This prospective study was carried out during the period of January 2007 to December 2011 in Mymensingh Medical College Hospital and other private clinics of Mymensingh town to assess the results of Ilizarov technice for nonunion of the tibia. Here total operated patient were 30, of them 24 were male and 6 were female. 10 cases are hypertrophic, 8 cases are atrophic and 12 cases are infected nonunion. In this series age of the patients was 10 ? 60 years. Motor vehicle accident was the commonest cause of fracture found in 66.67% cases. Second most common cause of injury was fall from height. Among 30 patients proximal corticotomy was done in 24 patient and distal corticomy in 2 patient. Union time was 4-12 months. Among 30 patients 27 were united at initial procedure. From nonunited 3 cases again refreshening of the ends along with bone grafting was done and ultimately 2 were united and 1 remains nonunited. In this series limb length discrepancy reduced to maximum 1.5 cm with contralateral limbs. Average total hospital stay was 15 days. Pin site infection and pain were the commonest complications in our study. Close adherences to Ilizarov principles make it now possible to successfully treat a most of orthopaedic conditions that previously were fraught with high morbidity rates and poor results. DOI: http://dx.doi.org/10.3329/cbmj.v2i2.16697 Community Based Medical Journal 2013 July: Vol.02 No 02: 41-45

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