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Updated: Jul 7, 2025
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Design of Cecal Ligation and Puncture and Intranasal Infection Dual Model of Sepsis-Induced Immunosuppression
Published on: June 15, 2019
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Optimized Treatment of Nosocomial Peritonitis
Jan J De Waele1,2, Federico Coccolini3, Leonel Lagunes4,5
1Department of Intensive Care Medicine, Ghent University Hospital, 9000 Ghent, Belgium.
Antibiotics (Basel, Switzerland)
|December 23, 2023
Summary
Nosocomial peritonitis (NP) is a critical complication in surgical patients, often caused by multi-drug resistant bacteria. This review guides intensivists on diagnosing and managing NP to improve patient outcomes and reduce mortality.
Area of Science:
- Critical care medicine
- Infectious diseases
- Surgical pathology
Background:
- Nosocomial peritonitis (NP) significantly increases mortality in surgical patients worldwide.
- NP is a hospital-acquired infection, often linked to gastrointestinal surgery or other diseases.
- It is a leading cause of sepsis in surgical Intensive Care Units (ICUs), frequently involving multi-drug resistant (MDR) bacteria.
Purpose of the Study:
- To offer a practical guide for intensivists on managing nosocomial peritonitis (NP).
- To review the epidemiology, diagnosis, and contemporary management strategies for NP.
- To highlight challenges and future research directions in NP treatment.
Main Methods:
- Comprehensive literature review focusing on NP epidemiology, diagnosis, and management.
- Discussion of diagnostic tools including biomarkers and imaging.
- Analysis of current antimicrobial strategies, source control, and novel treatment options.
Main Results:
- Early suspicion and prompt diagnosis are crucial for effective NP management.
- Antimicrobial resistance, including fungal infections, presents significant challenges.
- Source control and tailored antimicrobial regimens are key components of treatment.
Conclusions:
- Effective NP management requires a multidisciplinary approach, integrating diagnostics, source control, and appropriate antimicrobial therapy.
- Further research is needed to optimize treatment strategies for NP, particularly concerning MDR organisms and fungal infections.
- The role of advanced techniques like open abdomen treatment warrants further investigation.
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