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

  • Matteo BassettiEmail author
  • Christian Eckmann
  • Daniele Roberto Giacobbe
  • Massimo Sartelli
  • Philippe Montravers
Narrative Review
Part of the following topical collections:
  1. Severe infections in the critically ill

Abstract

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.

Keywords

IAI Source control Antimicrobial resistance Peritonitis Candidiasis Abdominal infections 

Notes

Compliance with ethical standards

Conflicts of interest

Outside the submitted work, MB has received funding for scientific advisory boards, travel and speaker honoraria from Angelini, Astellas, AstraZeneca, Basilea, Bayer, BioMérieux, Cidara, Correvio, Cubist, Menarini, Molteni, MSD, Nabriva, Paratek, Pfizer, Roche, Shionogi, Tetraphase, Thermo Fisher, and The Medicine Company. DRG reports personal fees from Stepstone Pharma GmbH and an unconditioned grant from MSD Italia. PM has received funding for scientific advisory boards travel and speaker honoraria from Astra Zeneca, Basilea, Bayer, Menarini, MSD, Parexel, The Medicines Company, Pfizer and Tetraphase. CE has received speaker honoraria from Angelini, Astellas, AstraZeneca, Menarini, MSD, Nabriva and Pfizer. MS declares no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Health SciencesUniversity of GenoaGenoaItaly
  2. 2.Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCSGenoaItaly
  3. 3.Department of General, Visceral and Thoracic Surgery, Klinikum PeineAcademic Hospital of Medical University HannoverPeineGermany
  4. 4.Department of SurgeryMacerata HospitalMacerataItaly
  5. 5.Département d’Anesthésie-Réanimation, CHU Bichat-Claude Bernard, HUPNVS, APHPParisFrance
  6. 6.Université de Paris, INSERM, UMR 1152ParisFrance

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