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

  • Narrative Review
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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.

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Authors and Affiliations

  1. Department of Health Sciences, University of Genoa, Genoa, Italy

    Matteo Bassetti & Daniele Roberto Giacobbe

  2. Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCS, L.go R. Benzi 10, 316132, Genoa, Italy

    Matteo Bassetti & Daniele Roberto Giacobbe

  3. Department of General, Visceral and Thoracic Surgery, Klinikum Peine, Academic Hospital of Medical University Hannover, Peine, Germany

    Christian Eckmann

  4. Department of Surgery, Macerata Hospital, Macerata, Italy

    Massimo Sartelli

  5. Département d’Anesthésie-Réanimation, CHU Bichat-Claude Bernard, HUPNVS, APHP, Paris, France

    Philippe Montravers

  6. Université de Paris, INSERM, UMR 1152, Paris, France

    Philippe Montravers

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Correspondence to Matteo Bassetti.

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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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Bassetti, M., Eckmann, C., Giacobbe, D.R. et al. Post-operative abdominal infections: epidemiology, operational definitions, and outcomes. Intensive Care Med 46, 163–172 (2020). https://doi.org/10.1007/s00134-019-05841-5

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