Recommendations for intra-abdominal infections consensus report

Avkan-Oğuz, Vildan; Baykam, Nurcan; Sökmen, Selman; Güner, Rahmet; Agalar, Fatih; Alp, Emine; Doğrul, Ahmet; Turhan, Özge; Ağalar, Canan; Kurtaran, Behice; Geçim, İbrahim Ethem; Özaras, Reşat; Yılmaz, Gürdal; Akbulut, Ayhan; Köksal, İftihar

doi:10.5152/ucd.2016.3688

Cited by 8 publications

(9 citation statements)

References 46 publications

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“…Within three days after operation, the APACHE II score and SOFA score in the DSSI group was significantly higher than those in the non-DSSI group (P<0.01). The median and interquartile range of the APACHE II score in the DSSI group were 4.5 and [2][3][4][5][6][7] while those in the non-DSSI group were 7 and (2-11.75), respectively (P<0.01).…”

Section: The Nfi Was Positively Correlated With the Apache II And Sofa Scorementioning

confidence: 90%

“…Early source identification and control were considered fundamental to the treatment of most patients with DSSI, since early institution of appropriate therapy is associated with improved outcomes. In current clinical practice, an increasing number of surgical practitioners realize the paucity of laboratory studies regarding the clinical diagnosis and treatment of DSSI (5). It is imminent that a new biomarker should be discovered to predict local infection source early and accurately in patients after laparotomy.…”

Section: Introductionmentioning

confidence: 99%

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Neutrophil extracellular trap formation index predicts occurrences of deep surgical site infection after laparotomy

Duan¹,

Sun²,

Qu³

et al. 2021

Ann Transl Med

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Background: Deep surgical site infections (DSSIs) are serious complications after laparotomy. Neutrophil extracellular traps (NETs) play a vital role in the development of DSSI. Here, we focused on a new approach to predicting the occurrence of DSSI through the detection of the NET formation index (NFI), and compared its prediction ability with other clinical infection indicators. Methods: Patients who received laparotomy were prospectively enrolled in this study. General information, APACHE II score, SOFA score, and serum infection indicators were recorded. The postoperative abdominal drainage fluid was collected within 3 days after the operation for quantification of the NFI.Results: A total of 92 consecutive patients were included, with 22 patients were diagnosed with DSSI.The NFI in the DSSI group was 32.70%±19.33% while the corresponding index was 10.70%±8.25% in the non-DSSI group (P<0.01). The mean APACHE II and SOFA score had significant differences between the two groups. The NFI was positively correlated with the APACHE II score (P<0.01, r=0.269) and SOFA score (P=0.013, r=0.258). Patients with a high NFI (NFI >13.86%) had a higher risk of developing DSSI.According to the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC) of the NFI, C-reactive protein (CRP) and procalcitonin (PCT) were 0.912, 0.748 and 0.731, respectively. Conclusions:In this cohort of surgical patients, the quantification of the NFI had a considerable predictive value for early identification of DSSI. The NFI in drainage fluid turned out to be a more sensitive and specific predictor of DSSI than serum infection indicators including CRP and PCT.

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Section: The Nfi Was Positively Correlated With the Apache II And Sofa Scorementioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Neutrophil extracellular trap formation index predicts occurrences of deep surgical site infection after laparotomy

Duan¹,

Sun²,

Qu³

et al. 2021

Ann Transl Med

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“…In the most general sense, IAI referred to infection in the pelvis, subdiaphragmatic spaces, or any other localized collection within the abdomen (with or [rarely] without involvement of the overlying peritoneum) with clinical signs: pyrexia >38 °C, pus from discharging cavities, aspirates of intra-abdominal collections or upon exploration of the abdomen, increased levels of inflammatory markers (white cell count), positive fluid, or blood culture. [ 15 , 18 – 24 ] IAI presented as generalized peritonitis or as a localized abscess, and necessitates treatment with antibiotics or surgical intervention. Preoperative portal hypertension (PHT) was evaluated retrospectively: direct measurement of venous pressure was not undertaken routinely in our series.…”

Section: Methodsmentioning

confidence: 99%

Risk factors and long-term outcome for postoperative intra-abdominal infection after hepatectomy for hepatocellular carcinoma

Tang

Lü²,

Yang³

et al. 2017

Medicine

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Intra-abdominal infection (IAI) after hepatectomy is an important morbidity. Identification of risk factors that could be avoided in the perioperative period may reduce the prevalence of IAI after hepatectomy for hepatocelluar carcinoma (HCC).Between January 1995 and December 2009, all patients with HCC who underwent curative liver resection were evaluated retrospectively. Long-term outcomes were compared in IAI patients and non-IAI patients after hepatectomy. Preoperative, intraoperative, and tumor-related factors that could be independent factors for postoperative IAI were identified.Of 622 patients with HCC, 24 patients (3.9%) had IAI after hepatectomy. Both median survival and survival of patients with postoperative IAI were shorter than those for non-IAI patients (P < .05). Upon univariate analysis followed by multivariate analyses, three independent predictors for IAI were identified: weight loss (odds ratio [OR], 3.27; 95% confidence interval [CI], 1.17–9.11; P = .024), liver cirrhosis (0.28, 0.12–0.67, .004), and operative time >300 minutes (3.44, 1.46–8.12, .005).IAI after hepatectomy affects outcome adversely. Preoperative weight loss, liver cirrhosis, and operative time >300 minutes are independent predictors of postoperative IAI.

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“…In Turkey, perioperative culture rates in cIAI cases vary across operations. In a recent study in our country, surgeons took samples for culture in 94.7% of intra-abdominal abscess and 9.6% of acute appendicitis (20). In another study, pediatric surgeons had taken intraoperative cultures in 20% in acute and 67% perforated appendicitis (9).…”

Section: Wementioning

confidence: 99%

Antimicrobial Resistance and Molecular Patterns in Community-acquired Complicated Intra-abdominal Infections: A Multicentric Study

Oğuz

Baykam

Korten

et al. 2020

Infect Dis Clin Microbiol

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Objective: We aimed to analyze antimicrobial susceptibilities by a molecular evaluation of extended-spectrum beta-lactamase (ESBL) positive of the isolates from communityacquired complicated intra-abdominal infections (CA-IAIs) in Turkey. Method: Clinical samples were obtained during operation. Antimicrobial susceptibilities, inducible beta-lactamase and ESBL status, were determined using Clinical and Laboratory Standards Institute criteria and interpretive standards. ESBL positive and cefoxitin-resistant isolates were evaluated bla genes for CTX-M, TEM, SHV, PER-1 and plasmidic AmpC families with polymerase chain reaction (PCR). We confirmed the results by directly sequencing the bla genes (Macrogen Inc, Korea) with Mega 5.02 and BLAST programs. Results: We isolated 116 pathogens from 81 patients. Clinicians diagnosed 34 (42.1%) patients as acute appendicitis, 15 (18.5%) as cholecystitis, 14 (17.3%) as intra-abdominal abscess, 12 (14.8%) as tumor resection and six (7.3%) acute diverticulitis. Escherichia coli (E. coli) was the most common gram-negative (76%), Enterococcus spp. was the most common gram-positive (13.6%). ESBL production was 12, 3 % in all gram-negative strains; 11, 1% (9/62) in E. coli and 1, 2% (1/9) Klebsiella pneumoniae (K. pneumonia). Quinolone resistance was 22.2% and ceftriaxone resistance was 14.5% in E. coli. We detected CTX-M genes in five of nine ESBL positive isolates. CTX-M-1 group (CTX-M-1, CTX-M-3, and CTX-M-15) was in four and CTX-M-9 group (CTX-M-14) in one ESBL positive E. coli. One isolate had also AmpC, CMY-2 enzyme (1, 6 %). Conclusion: In our study, ESBL positive gram-negative pathogens were >10%. Quinolone resistance was >% 20, so that quinolones should not be the first choice for the treatment of serious IAI's in our country. Cefoxitin resistance was still low in E. coli isolates from CA-IAIs. Regular surveillance data can guide empirical antibiotic therapy in community-acquired intra-abdominal infections. It should emphasize the importance of sampling for culture to surgeons for guiding empirical therapy in the future.

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Recommendations for intra-abdominal infections consensus report

Cited by 8 publications

References 46 publications

Neutrophil extracellular trap formation index predicts occurrences of deep surgical site infection after laparotomy

Neutrophil extracellular trap formation index predicts occurrences of deep surgical site infection after laparotomy

Risk factors and long-term outcome for postoperative intra-abdominal infection after hepatectomy for hepatocellular carcinoma

Antimicrobial Resistance and Molecular Patterns in Community-acquired Complicated Intra-abdominal Infections: A Multicentric Study

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