Post-operative abdominal infections: epidemiology, operational definitions, and outcomes

• Published in: Intensive care medicine Vol. 46; no. 2; pp. 163 - 172
• Main Authors: Bassetti, Matteo, Eckmann, Christian, Giacobbe, Daniele Roberto, Sartelli, Massimo, Montravers, Philippe
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2020; Springer; Springer Nature B.V
• Subjects: Abdomen; Abscess; Anesthesiology; Antifungal agents; Antiinfectives and antibacterials; Antimicrobial agents; Care and treatment; Critical Care Medicine; Drug resistance in microorganisms; Emergency Medicine; Epidemiology; Fungi; Health aspects; Heterogeneity; Hospitals; Infection; Infections; Intensive; Intensive care units; Medicine; Medicine & Public Health; Methicillin; Multidrug resistance; Narrative Review; Pain Medicine; Pathogens; Pediatrics; Pneumology/Respiratory System; Severe infections in the critically ill; Canada; IAI; Candidiasis; Source control; Antimicrobial resistance; Peritonitis; Abdominal infections
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-019-05841-5

Postoperative abdominal infections are an important and heterogeneous health challenge in intensive care units (ICU) and encompass postoperative infectious processes developing within the abdominal cavity that may be caused by either bacterial or fungal pathogens. In this narrative review, we discuss postoperative bacterial and fungal abdominal infections, covering also multidrug-resistant (MDR) pathogens. We also cover clinically preeminent aspects such as the definition of postoperative abdominal infections, which still remains difficult owing to their heterogeneity in patient characteristics, clinical presentation, ecology and antimicrobial treatment. With regard to treatment, modifiable factors such as source control and antimicrobial therapy play a key role in influencing the prognosis of postoperative abdominal infections, but several conditions may hamper their correct application; thus efforts should necessarily be devoted towards improving their appropriateness and timing. Hot topics regarding the characteristics and management of postoperative abdominal infections are discussed in this narrative review.