25 research outputs found
Issledovanie muragennosti vybrannykh aromaticheskikh aminov, ispol'zuemukh v kachestve krasitelejj bolos, metodom khromosomnykh aberracijj
No full textBody mass index and mortality: The “Obesity Paradox” in critically ill patients with intra-abdominal infection or sepsis – An international cohort study
No full texthttp://dx.doi.org/10.13039/501100013347 European Society of Intensive Care Medicinehttp://dx.doi.org/10.13039/100004319 Pfizer In
Wytyczne Polskiego Towarzystwa Anestezjologii i Intensywnej Terapii określające zasady, warunki oraz organizację udzielania świadczeń zdrowotnych w dziedzinie anestezjologii i intensywnej terapii
No full textYear in review in Intensive Care Medicine 2012. II: Pneumonia and infection, sepsis, coagulation, hemodynamics, cardiovascular and microcirculation, critical care organization, imaging, ethics and legal issues
No full textNon
Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection
No full text20.500.12530/87857The AbSeS-classification defines specific phenotypes of patients with intra-abdominal infection based on the (1) setting of infection onset (community-acquired, early onset, or late-onset hospital-acquired), (2) presence or absence of either localized or diffuse peritonitis, and (3) severity of disease expression (infection, sepsis, or septic shock). This classification system demonstrated reliable risk stratification in intensive care unit (ICU) patients with intra-abdominal infection. This study aimed to describe the epidemiology of ICU patients with pancreatic infection and assess the relationship between the components of the AbSeS-classification and mortality. This was a secondary analysis of an international observational study ("AbSeS") investigating ICU patients with intra-abdominal infection. Only patients with pancreatic infection were included in this analysis (n=165). Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the ICU. Relationships with mortality were assessed using logistic regression analysis and reported as odds ratio (OR) and 95% confidence interval (CI). The overall mortality was 35.2% (n=58). The independent risk factors for mortality included older age (OR=1.03, 95% CI: 1.0 to 1.1 P=0.023), localized peritonitis (OR=4.4, 95% CI: 1.4 to 13.9 P=0.011), and persistent signs of inflammation at day 7 (OR=9.5, 95% CI: 3.8 to 23.9, P In pancreatic infection, a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term outcome. In this limited series, essentials of the AbSeS-classification, such as the setting of infection onset, diffuse peritonitis, and severity of disease expression, were not associated with an increased mortality risk.ClinicalTrials.gov number: NCT03270345
Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection
No full textBackground
The AbSeS-classification defines specific phenotypes of patients with intra-abdominal infection based on the (1) setting of infection onset (community-acquired, early onset, or late-onset hospital-acquired), (2) presence or absence of either localized or diffuse peritonitis, and (3) severity of disease expression (infection, sepsis, or septic shock). This classification system demonstrated reliable risk stratification in intensive care unit (ICU) patients with intra-abdominal infection. This study aimed to describe the epidemiology of ICU patients with pancreatic infection and assess the relationship between the components of the AbSeS-classification and mortality.
Methods
This was a secondary analysis of an international observational study (“AbSeS”) investigating ICU patients with intra-abdominal infection. Only patients with pancreatic infection were included in this analysis (n=165). Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the ICU. Relationships with mortality were assessed using logistic regression analysis and reported as odds ratio (OR) and 95% confidence interval (CI).
Results
The overall mortality was 35.2% (n=58). The independent risk factors for mortality included older age (OR=1.03, 95% CI: 1.0 to 1.1 P=0.023), localized peritonitis (OR=4.4, 95% CI: 1.4 to 13.9 P=0.011), and persistent signs of inflammation at day 7 (OR=9.5, 95% CI: 3.8 to 23.9, P<0.001) or after the implementation of additional source control interventions within the first week (OR=4.0, 95% CI: 1.3 to 12.2, P=0.013). Gram-negative bacteria were most frequently isolated (n=58, 49.2%) without clinically relevant differences in microbial etiology between survivors and non-survivors.
Conclusions
In pancreatic infection, a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term outcome. In this limited series, essentials of the AbSeS-classification, such as the setting of infection onset, diffuse peritonitis, and severity of disease expression, were not associated with an increased mortality risk
a descriptive analysis of the Eurobact II study
No full textFunding Information: The Eurobact 2 study group, National coordinators, scientific committee and participating intensive care units: East Asia and Pacific: Australia —National Coordinator: A/Prof. Alexis Tabah; Scientific Committee: Prof. Jeffrey Lipman; Participating ICUs: The Prince Charles Hospital, Adult Intensive Care Services: Dr. Mahesh Ramanan. Fiona Stanley Hospital, Intensive Care Unit: Dr. Edward Litton, Ms Anna Maria Palermo, Mr Timothy Yap, Mr Ege Eroglu. Japan —National Coordinator: Dr. Yoshiro Hayashi; Participating ICUs: Hiroshima University Hospital, ICU: Dr. Koji Hosokawa. St. Marianna University School of Medicine Hospital, Mixed ICU: Dr. Hideki Yoshida, Prof. Shigeki Fujitani. Middle East and North Africa: Iran —National Coordinator: Prof. Farid Zand; Participating ICUs: Imam-Reza, General Icu: Prof Ata Mahmoodpoor. Zahedan University of Medical Sciences, Clinical Immunology Research Center: Dr. Seyed Mohammad Nasirodin (S.M.N.) Tabatabaei. Saudi Arabia —Participating ICUs: Prince Sultan Medical Military Center, Intensive Care Unit: Dr. Omar Elrabi, Dr. Ghaleb A Almekhlafi. Latin America and The Caribbean: Argentina —National Coordinator: Dr. Gabriela Vidal; Participating ICUs: Hospital Zatti, Ucia: Dra Marta Aparicio, Microbiologa Irene Alonzo. Mexico —National Coordinator: Dr. Silvio A. Namendys-Silva; Participating ICUs: Centenario Hospital Miguel Hidalgo: Dr. Mariana Hermosillo, Dr. Roberto Alejandro Castillo. Europe And Central Asia: Belgium —National Coordinator: Dr. Liesbet De Bus; Scientific Committee: Jan De Waele; Participating ICUs: A.S.Z., Iz: Dr. Isabelle Hollevoet. Clinique Saint-Pierre, Intensive Care Unit: Dr. Nicolas De Schryver, Dr. Nicolas Serck. Bosnia And Herzegovina —National Coordinator: Dr. Pedja Kovacevic; Participating ICUs: University Clinical Centre of The Republic Of Srpska, Medical Intensive Care Unit: Dr. Pedja Kovacevic, Dr. Biljana Zlojutro. France —National Coordinator: Prof. Marc Leone; Scientific Committee: Prof. Jean-François Timsit, Prof. Etienne Ruppe, Mr. Stephane Ruckly, Prof. Philippe Montravers; Participating ICUs: Centre Hospitalier De Bigorre, Service De Réanimation Polyvalente: Dr. Thierry Dulac, Dr. Jérémy Castanera. Centre Hospitalier De Pau, Réanimation Polyvalente: Dr. Alexandre Massri, Dr. Charlotte Guesdon. Ghef Site De Marne-La-Vallée, Réanimation Polyvalente: Dr. Pierre Garcon, Dr. Matthieu Duprey. Groupe Hospitalier Paris Saint Joseph, Médecine Intensive et Réanimation: Dr. François Philippart, Dr. Marc Tran, Dr. Cédric Bruel. Hôpital De La Source, Centre Hospitalier Régional D'orléans, Médecine Intensive & Réanimation (Medical Icu): Dr. François Barbier. Hôpital Louis Pasteur, Réanimation: Dr. Pierre Kalfon, Mr Gaëtan Badre. Sorbonne Universite Pitie Salpetriere, Médecine Intensive Et Réanimation Neurologique: Dr. Sophie Demeret, Dr. Loïc Le Guennec. Italy —National Coordinator: Prof. Matteo Bassetti and Dr. Daniele Giacobbe; Participating ICUs: Città Della Salute E Della Scienza - Molinette, Anestesia E Rianimazione Universitaria: Dr. Giorgia Montrucchio, Dr. Gabriele Sales. Irccs Sacro Cuore Don Calabria, Terapia Intensiva: Dr. Ivan Daroui, Dr. Giovanni Lodi. Policlino Paolo Giaccone, Università Degli Studi Di Palermo, Terapia Intensiva Polivalente: Dr. Andrea Cortegiani, Dr. Mariachiara Ippolito, Dr. Davide Bellina, Dr. Andrea Di Guardo. Sant'andrea Hospital Sapienza University of Rome, Department of Medical And Surgical Science And Translational Medicine Intensive Care Unit: Dr. Monica Rocco, Dr. Silvia Fiorelli. Poland —National Coordinator: Dr. Adam Mikstacki; Participating ICUs: Wss Im. Wl. Bieganskiego, Oddzial Anestezjologii I Intensywnej Terapii - Osrodek Pozaustrojowych Technik Wspomagania Czynnosci Nerek I Wątroby: Prof Assoc Mariusz Peichota, Dr. Iwona Pietraszek-Grzywaczewska. Portugal —National Coordinator: Prof. José-Artur Paiva; Scientific Committee: Prof. Pedro Póvoa; Participating ICUs: CHUA Faro, Smi-1: Dr. Andriy Krystopchuk, Dr. Ana Teresa. Hospital De Cascais Dr Jose De Almeida, Unidade de Cuidados Intensivos: Dr. António Manuel Pereira de Figueiredo, Dr. Isabel Botelho. Hospital Sao Francisco Xavier, CHLO, Unidade De Cuidados Intensivos Polivalente: Dr. Vasco Costa, Dr. Rui Pedro Cunha. Russian Federation —National Coordinator: Prof Alexey Gritsan; Participating ICUs: Privolzhskiy District Medical Center, Department Anesthesiology and Intensive Care: Dr. Vladislav Belskiy, Dr. Mikhail Furman. Spain —National Coordinator: Dr. Ricard Ferrer; Participating ICUs: Vall D'herbon, Intensive Care Medicine: Dr. Ricard Ferrer, Dr. Maria Martinez, Dr. Vanessa Casares. Hospital Del Mar, Critical Care Unit: Dr. Maria Pilar Gracia Arnillas, Dr. Rosana Munoz Bermudez. Hospital Punta De Europa, Intensive Care Unit: Dr. Alejandro Ubeda, Dra Maria Salgado. Hospital Universitario La Paz, Surgical Critical Care Unit: Dr. Emilio Maseda, Dr. Alejandro Suarez De La Rica. University Hospital Severo Ochoa, Intensive Care Unit: Dr. Miguel Angel Blasco-Navalpotro, Dr. Alberto Orejas Gallego. Switzerland —National Coordinator: Dr. Josef Prazak; Scientific Committee: Dr. Niccolò Buetti; Participating ICUs: Chuv, Service De Médecine Intensive Adulte: Dr. Jl Pagani, Mrs S Abed-Maillard. Turkey —National Coordinator: Prof. Akova Murat, Dr. Abdullah Tarık Aslan; Participating ICUs: Hacettepe University of Faculty of Medicine, Intensive Care Unit(ICU): Dr. Akova Murat, Dr. Abdullah Tarik Aslan, Dr. Arzu Topeli Iskit. Acibadem Kadikoy Hospital, ICU: Dr. Selcuk Mehtap, Dr. Solakoğlu Ceyhun. Ankara Yildirim Beyazit University, Ankara City Hospital, Infectious Diseases and Clinical Microbiology: Dr. Bircan Kayaaslan, Dr. Ayşe Kaya Kalem. Aydin Adnan Menderes University Research Hospital, Anesthesia and Reanimation ICU: Prof. Dr. Ibrahim Kurt, Dr. (Professor) Murat Telli, Dr. (Associate Professor) Barcin Ozturk. Hitit University Erol Olcok Education and Research Hospital, Infectious Diseases and Clinical Microbiology: Prof. Dr. Nurcan (N) Baykam, Assistant Prof. Dr. Özlem (O) Akdoğan. Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Sadi Sun ICU: Prof.Dr. Nese Saltoglu, Ass Prof.Dr. Ridvan Karaali. Karadeniz Technical University Faculty of Medicine, Infectious Disease and Clinical Microbiology: Prof Dr. Iftihar Koksal, Assist. Prof. Firdevs Aksoy. Kartal Dr. Lutfi Kirdar Training and Research Hospital, ICU: Dr. Kemal Tolga Saracoglu, Dr. Yeliz Bilir. Kayseri City Hospital, ICU: Dr. Seda Guzeldag. Mersin University Hospital, Department of Infectious Diseases and Clinical Microbiology: Dr. Gulden Ersoz, Dr. Guliz Evik. School Of Medicine, Medipol Mega University Hospitals Complex, Department of Anesthesiology and Reanimation: Dr. Cem Erdogan. Turgut Ozal Medical Center, Department of Infectious Diseases and Clinical Microbiology: Dr. Yasar Bayindir, Dr. Yasemin Ersoy. The United Kingdom —National Coordinator: Dr. Andrew Conway Morris; Participating ICUs: Addenbrookes Hospital, John V Farman Intensive Care Unit: Dr. Andrew Conway Morris, Dr. Matthew Routledge. Addenbrookes Hospital, Neurocritical Care Unit (NCCU): Dr. Andrew Conway Morris, Dr. Ari Ercole. Croydon University Hospital, Critical Care Unit: Dr. Ashok Raj, Dr. Artemis Zormpa, Dr. George Tinaslanidis, Mrs Reena Khade. Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, Critical Care Unit: Dr. Ashraf Roshdy Sandwell And West Birmingham Hospitals NHS Trust, Intensive Care Unit: Dr. Santhana Kannan, Dr. Supriya Antrolikar, Dr. Nicholas Marsden. Warwick Hospital, Intensive Care Unit: Dr. Ben Attwood, Dr. Jamie Patel. South Asia: India —National Coordinator: Prof. Mohan Gurjar; Participating ICUs: St Johns Medical College Hospital, Department of Critical Care Medicine, Micu: Dr. Carol Dsilva, Dr. Jagadish Chandran. Sub-Saharan Africa: Sudan —National Coordinator: Dr. Bashir El Sanousi; Participating ICUs: East Nile Hospital, Intensive Care Unit: Dr. Elfayadh Saidahmed, Dr. Hytham K.S. Hamid. Funding Information: The authors have disclosed that they do not have conflict of interest. Dr. Buetti received a grant from the Swiss National Science Foundation (Grant Number: P4P4PM_194449). Prof. Timsit received fees for lectures to 3M, MSD, Pfizer, and BioMérieux; he received research grants from Astellas, 3M, MSD, and Pfizer; and he participated to advisory boards of 3M, MSD, Bayer Pharma, Nabriva, and Pfizer. Dr. Barbier received consulting and lecture fees from MSD and BioMérieux. Prof. Cortegiani received fees for lectures from Gilead, MSD, Pfizer; and he participated to advisory boards of MSD, Gilead, Pfizer. Dr. Montrucchio received fees for lectures from Gilead, Pfizer, Thermofisher; and she participated to advisory boards of Gilead. Dr. Conway Morris sits on the scientific advisory board of Cambridge Infection Diagnostics. Prof. Akova received grants from Pfizer and Gilead, had lecture fees paid to the institution by Pfizer and Sanofi. Dr. Ramanan acknowledges support from the Metro North Hospital and Health Services Clinician-Researcher Fellowship. Dr. Conway Morris sits on the scientific advisory board of Cambridge Infection Diagnostics. Dr. Conway Morris is supported by a Clinician Scientist Fellowship from the Medical Research Council (MR/V006118/1). Prof. José-Artur Paiva received fees for consulting, advisory boards or lectures from MSD, Pfizer, Astra-Zeneca, Gilead, Jansen, Cepheid, AOP Orphan Pharmaceuticals. Funding Information: Research grants were obtained from the European society of Intensive Care Medicine (ESICM) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study Group for Infections in Critically Ill Patients (ESGCIP), the Norva Dahlia foundation and the Redcliffe Hospital Private Practice Trust Fund. Dr. Buetti received a grant from the Swiss National Science Foundation (Grant Number: P4P4PM_194449). The study was endorsed by the critically ill group of the ESCMID (ESGCIP) and by the infection group of the ESICM with scientific input of the OUTCOMEREA network. Publisher Copyright: © 2022, The Author(s).Background: The study aimed to describe the epidemiology and outcomes of hospital-acquired bloodstream infections (HABSIs) between COVID-19 and non-COVID-19 critically ill patients. Methods: We used data from the Eurobact II study, a prospective observational multicontinental cohort study on HABSI treated in ICU. For the current analysis, we selected centers that included both COVID-19 and non-COVID-19 critically ill patients. We performed descriptive statistics between COVID-19 and non-COVID-19 in terms of patients’ characteristics, source of infection and microorganism distribution. We studied the association between COVID-19 status and mortality using multivariable fragility Cox models. Results: A total of 53 centers from 19 countries over the 5 continents were eligible. Overall, 829 patients (median age 65 years [IQR 55; 74]; male, n = 538 [64.9%]) were treated for a HABSI. Included patients comprised 252 (30.4%) COVID-19 and 577 (69.6%) non-COVID-19 patients. The time interval between hospital admission and HABSI was similar between both groups. Respiratory sources (40.1 vs. 26.0%, p < 0.0001) and primary HABSI (25.4% vs. 17.2%, p = 0.006) were more frequent in COVID-19 patients. COVID-19 patients had more often enterococcal (20.5% vs. 9%) and Acinetobacter spp. (18.8% vs. 13.6%) HABSIs. Bacteremic COVID-19 patients had an increased mortality hazard ratio (HR) versus non-COVID-19 patients (HR 1.91, 95% CI 1.49–2.45). Conclusions: We showed that the epidemiology of HABSI differed between COVID-19 and non-COVID-19 patients. Enterococcal HABSI predominated in COVID-19 patients. COVID-19 patients with HABSI had elevated risk of mortality. Trial registration ClinicalTrials.org number NCT03937245. Registered 3 May 2019.publishersversionpublishe
Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project
No full textPurposeTo describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock).MethodsWe performed a multicenter (n=309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis.ResultsThe cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation.ConclusionThis multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection
Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project
No full textPurpose: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection. © 2019, The Author(s)
