Outcome of community- versus hospital-acquired intra-abdominal infections in intensive care unit: a retrospective study

Timothée Abaziou (1) , Fanny Vardon-Bounes (2) , Jean-Marie Conil (2) , Antoine Rouget , Stéphanie Ruiz (2) , Marion Grare (3) , Olivier Fourcade (4) , Bertrand Suc (5) , Marc Leone (6) , Vincent Minville (1) , Bernard Georges

1 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
2 Pôle Anesthésie Réanimation [CHU de Toulouse]
3 Service Bactériologie et hygiène [CHU Toulouse]
4 Service Cardiologie [CHU Toulouse]
5 Chirurgie Générale et Digestive [Rangueil]
6 MEPHI - Microbes évolution phylogénie et infections

Background To compare patients hospitalised in the intensive care unit (ICU) after surgery for community-acquired intra-abdominal infection (CA-IAI) and hospital-acquired intra-abdominal infection (HA-IAI) in terms of mortality, severity and complications. Methods Retrospective study including all patients admitted to 2 ICUs within 48 h of undergoing surgery for peritonitis. Results Two hundred twenty-six patients were enrolled during the study period. Patients with CA-IAI had an increased 28-day mortality rate compared to those with HA-IAI (30% vs 15%, respectively (p = 0.009)). At 90 days, the mortality rates were 36.7 and 37.5% in the CA-IAI group and HA-IAI group, respectively, with a similar APACHE II score on admission (median: 21 [15–25] vs. 21 [15–24] respectively, p = 0.63). The patients with HA-IAI had prolonged ICU and hospital stays (median: 17 [7–36] vs. 6[3–12] days, p < 0.001 and 41 [24–66] vs. 17 [7–32] days, p = 0.001), and experienced more complications (reoperation and reintubation) than those with CA-IAI. Conclusion CA-IAI group had higher 28-day mortality rate than HA-IAI group. Mortality was similar at 90 days but those with HA-IAI had a prolonged ICU and hospital stay. In addition, they developed more complications.

Mots clés: Intra-abdominal infection; Peritonitis; Outcome; Microbiology; Intensive care unit

Domaines: Bactériologie; Cardiologie et système cardiovasculaire; Maladies émergentes; Maladies infectieuses; Parasitologie; Virologie

Timothée Abaziou, Fanny Vardon-Bounes, Jean-Marie Conil, Antoine Rouget, Stéphanie Ruiz, et al.. Outcome of community- versus hospital-acquired intra-abdominal infections in intensive care unit: a retrospective study. BMC Anesthesiology, 2020, 20 (1), ⟨10.1186/s12871-020-01209-1⟩. ⟨hal-03159748⟩