Imperial College London
Ben Creagh-Brown

Ben Creagh-Brown

Faculty of Medicine, National Heart & Lung Institute

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

b.creagh-brown08

 
 
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Location

 

Royal BromptonRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Vogelaers:2021:10.1007/s40265-021-01534-w,
author = {Vogelaers, D and Blot, S and Van, den Berge A and Montravers, P and Abdominal, Sepsis Study AbSeS Group on behalf of the Trials Group of the European Society of Intensive Care Medicine},
doi = {10.1007/s40265-021-01534-w},
journal = {Drugs},
pages = {1065--1078},
title = {Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units.},
url = {http://dx.doi.org/10.1007/s40265-021-01534-w},
volume = {81},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Severe intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. In this study, we report on resistance profiles of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis and Enterococcus faecium in distinct European geographic regions based on an observational cohort study on intra-abdominal infections in intensive care unit (ICU) patients. Resistance against aminopenicillins, fluoroquinolones, and third-generation cephalosporins in E. coli, K. pneumoniae and P. aeruginosa is problematic, as is carbapenem-resistance in the latter pathogen. For E. coli and K. pneumoniae, resistance is mainly an issue in Central Europe, Eastern and South-East Europe, and Southern Europe, while resistance in P. aeruginosa is additionally problematic in Western Europe. Vancomycin-resistance in E. faecalis is of lesser concern but requires vigilance in E. faecium in Central and Eastern and South-East Europe. In the subcohort of patients with secondary peritonitis presenting with either sepsis or septic shock, the appropriateness of empiric antimicrobial therapy was not associated with mortality. In contrast, failure of source control was strongly associated with mortality. The relevance of these new insights for future recommendations regarding empiric antimicrobial therapy in intra-abdominal infections is discussed.
AU  - Vogelaers,D
AU  - Blot,S
AU  - Van,den Berge A
AU  - Montravers,P
AU  - Abdominal,Sepsis Study AbSeS Group on behalf of the Trials Group of the European Society of Intensive Care Medicine
DO  - 10.1007/s40265-021-01534-w
EP  - 1078
PY  - 2021///
SP  - 1065
TI  - Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units.
T2  - Drugs
UR  - http://dx.doi.org/10.1007/s40265-021-01534-w
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34037963
VL  - 81
ER  -
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