| Title |
Clinical characteristics and prognosis of bacteraemia during postoperative intra-abdominal infections
|
|---|---|
| Published in |
Critical Care, July 2018
|
| DOI | 10.1186/s13054-018-2099-5 |
| Pubmed ID | |
| Authors |
Adel Alqarni, Elie Kantor, Nathalie Grall, Sebastien Tanaka, Nathalie Zappella, Mathieu Godement, Lara Ribeiro-Parenti, Alexy Tran-Dinh, Philippe Montravers |
| Abstract |
Bloodstream infections of abdominal origin are usually associated with poor prognosis. We assessed the clinical and microbiological characteristics of critically ill patients admitted to the intensive care unit (ICU) for postoperative intra-abdominal infection (PIAI) and analysed the influence of bacteraemia on their outcome. All consecutive PIAI patients admitted to the ICU between 1999 and 2014 were prospectively analysed. Bacteraemic patients (at least one positive blood culture in the 24 h preceding/following surgery) were compared with non-bacteraemic patients. Demographic characteristics, underlying disease, severity scores at the time of reoperation, microbiological results, therapeutic management, outcome, and survival were recorded. Results are expressed as median (interquartile range (IQR)) or proportions. Overall, 343 patients (54% male, 62 (49-73) years old) with PIAI were analysed, including 64 (19%) bacteraemic patients. Immunosuppression and cancer were more frequent in bacteraemic patients (p < 0.001 in both cases). No difference between groups was observed for the characteristics of initial surgery. Time to reoperation, site, and cause of PIAI were similar in both groups. At the time of reoperation, Sequential Organ Failure Assessment (SOFA) score was higher in bacteraemic patients (8 (6-10) versus 7 (4-10); p < 0.05). A predominance of Gram-positive (34%) and Gram-negative (47%) bacteria were recovered from blood cultures (polymicrobial bacteraemia in 9 (14%) patients and bacteraemia involving multidrug-resistant organisms in 14 (22%) patients). In multivariate analysis, risk factors for bacteraemia were immunosuppression or cancer, high SOFA score, and E. coli in peritoneal samples. Bacteraemia did not impact the management (with similar results for the adequacy of antibiotic therapy, anti-infective agents used, de-escalation or duration of therapy in both groups). Neither hospital mortality nor morbidity criteria differed between groups. Risk factors for mortality in multivariate analysis were urgent initial surgery, high Simplified Acute Physiology Score (SAPS) II score and documented antifungal therapy, but not perioperative bacteraemia. In this ICU population, bacteraemia did not change the overall management of patients with PIAI. Our data suggest that bacteraemic patients do not require a specific management. |
X Demographics
The data shown below were collected from the profiles of 32 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 2 | 6% |
| Colombia | 2 | 6% |
| Russia | 2 | 6% |
| France | 2 | 6% |
| Brazil | 2 | 6% |
| Malaysia | 1 | 3% |
| United States | 1 | 3% |
| Ecuador | 1 | 3% |
| Venezuela, Bolivarian Republic of | 1 | 3% |
| Other | 3 | 9% |
| Unknown | 15 | 47% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 25 | 78% |
| Practitioners (doctors, other healthcare professionals) | 5 | 16% |
| Science communicators (journalists, bloggers, editors) | 1 | 3% |
| Scientists | 1 | 3% |
Mendeley readers
The data shown below were compiled from readership statistics for 58 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 58 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 10 | 17% |
| Student > Postgraduate | 8 | 14% |
| Student > Bachelor | 6 | 10% |
| Student > Ph. D. Student | 5 | 9% |
| Professor | 3 | 5% |
| Other | 9 | 16% |
| Unknown | 17 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 26 | 45% |
| Biochemistry, Genetics and Molecular Biology | 3 | 5% |
| Immunology and Microbiology | 3 | 5% |
| Nursing and Health Professions | 2 | 3% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 3% |
| Other | 2 | 3% |
| Unknown | 20 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 18. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 August 2018.
All research outputs
#2,015,720
of 25,385,509 outputs
Outputs from Critical Care
#1,802
of 6,555 outputs
Outputs of similar age
#40,627
of 340,655 outputs
Outputs of similar age from Critical Care
#44
of 79 outputs
Altmetric has tracked 25,385,509 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,555 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one has gotten more attention than average, scoring higher than 72% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 340,655 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 88% of its contemporaries.
We're also able to compare this research output to 79 others from the same source and published within six weeks on either side of this one. This one is in the 44th percentile – i.e., 44% of its contemporaries scored the same or lower than it.