Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW Study

Abstract

The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter observational study underwent in 68 medical institutions worldwide during a six-month study period (October 2012-March 2013). The study included patients older than 18 years undergoing surgery or interventional drainage to address complicated intra-abdominal infections (IAIs).1898 patients with a mean age of 51.6 years (range 18-99) were enrolled in the study. 777 patients (41%) were women and 1,121 (59%) were men. Among these patients, 1,645 (86.7%) were affected by community-acquired IAIs while the remaining 253 (13.3%) suffered from healthcare-associated infections. Intraperitoneal specimens were collected from 1,190 (62.7%) of the enrolled patients.827 patients (43.6%) were affected by generalized peritonitis while 1071 (56.4%) suffered from localized peritonitis or abscesses.The overall mortality rate was 10.5% (199/1898).According to stepwise multivariate analysis (PR = 0.005 and PE = 0.001), several criteria were found to be independent variables predictive of mortality, including patient age (OR = 1.1; 95%CI = 1.0-1.1; p < 0.0001), the presence of small bowel perforation (OR = 2.8; 95%CI = 1.5-5.3; p < 0.0001), a delayed initial intervention (a delay exceeding 24 hours) (OR = 1.8; 95%CI = 1.5-3.7; p < 0.0001), ICU admission (OR = 5.9; 95%CI = 3.6-9.5; p < 0.0001) and patient immunosuppression (OR = 3.8; 95%CI = 2.1-6.7; p < 0.0001).

Recommendations for Intra-abdominal Infections “Consensus Report”

“…Lokalizasyona göre İAE'ye neden olan etkenler, çok ilaca dirençli mikroorganizmalar ve spesifik dirençli mikroorganizmalar için risk faktörleri Tablo 2, 3 ve 4'te verilmiştir [13][14][15][16] . Tablo 2.…”

“…Tablo 2. Lokalizasyona göre intra-abdominal enfeksiyonlar ve etkenler [13][14][15][16] Enfeksiyon Etken [9] . Tüm hastalarda DM, ciddi kardiyopulmoner hastalık, immünsüpresyon, hastane başvurusundan önceki üç ay içinde beş gün ve daha uzun süre hastane yatışı ve/veya iki günden fazla antibiyotik kullanımı ve/ veya abdominal girişim varlığı mutlaka sorgulanmalıdır (AMMI, A-II) [6] .…”

Management of Intra-Abdominal Infections

“…In the context of IAIs, the main resistance problem is posed by ESBL-producing Enterobacteriaceae, which are alarmingly prevalent in nosocomial infections and frequently observed in community-acquired infections [169][170][171]. A Carbapenem-sparing regimen is preferred.…”

Alcohol extract of Schinu sterebinthifolius raddi (anacardiaceae) as a local antimicrobial agent in severe autogenously fecal peritonitis in rats

“…It will turn into one large inflamed compartment in which the local defense mechanisms may become detrimental to the patient. The main risk factors for mortality in this disease are: patient age, the presence of small bowel perforation, a delayed initial intervention (a delay exceeding 24 hours), ICU admission, patient immunosuppression, and renal and respiratory comorbidities 2,3 . Secondary peritonitis is associated with in-hospital mortality rates of approximately 30% [4][5][6] .…”