Related Experiment Video
Updated: Mar 2, 2026
Colon Ascendens Stent Peritonitis CASP - a Standardized Model for Polymicrobial Abdominal Sepsis
Published on: December 18, 2010
Clinical landscape and mortality risk in Intensive Care Unit peritonitis in a low-MultiDrug Resistant setting: A
Charly Angebault1, Melchior Bardoul1, Pierre Fillâtre2
1Intensive Care Unit, Vannes Hospital Center, 56000 Vannes, France; Univ-Rennes, Surgical Intensive Care Unit, CHU de Rennes, 35000, Rennes, France.
Introduction:
Peritonitis is a frequent cause of sepsis in the intensive care unit (ICU) and is characterized by substantial microbiological variability, including multidrug-resistant organisms (MDROs).
Method:
We conducted a retrospective, multicenter cohort study including ICU patients diagnosed with intra-abdominal infection across 4 hospitals 2020-2022). The primary objective was to describe clinico-biological features, and microbiological characteristics according to the setting of the peritonitis (Community peritonitis (CP), early nosocomial peritonitis (ENP), or late nosocomial peritonitis (LNP)). Additionally, we analyzed 90-day survival using Kaplan-Meier curves and multivariable Cox regression.
Results:
Among the 392 patients included in the study period, 195 experienced a CP, 88 an ENP, and 109 an LNP. Extended-spectrum beta-lactamase-producing bacteria were identified in 24 patients (6.1%), and carbapenem-resistant bacteria in 5 patients (1.3%). MDRO rates differed significantly: carbapenem-resistant bacteria were more frequent in LNP patients (3.7% vs. 0.0% in CP and 0.5% in ENP; p = 0.03), and cephalosporinase-producing bacteria were more common in nosocomial settings (40.4% in LNP vs. 19.0% in CP; p < 0.001). Ninety-day mortality was 34.7% overall and did not differ across settings (p = 0.345). Age and SAPS II were independently associated with mortality. Finally, appropriate empirical antimicrobial therapy was not associated with improved 90-day survival (p = 0.128).
Conclusion:
Through this large cohort study of ICU patients with peritonitis, we observed a low prevalence of MDRO. Our findings challenge the relevance of broad-spectrum empirical therapy in low-MDRO regions and underscore the need for tailored antimicrobial stewardship strategies.
Insights
This study found a low prevalence of multidrug-resistant organisms (MDROs) in intensive care unit (ICU) peritonitis patients. Findings suggest that broad-spectrum empirical therapy may not be necessary in low-MDRO regions.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Peritonitis is a significant cause of sepsis in intensive care units (ICUs).
- Microbiological variability, including multidrug-resistant organisms (MDROs), complicates peritonitis treatment.
- Understanding peritonitis characteristics across different settings is crucial for effective management.
Purpose of the Study:
- To describe the clinical and microbiological features of peritonitis in ICU patients.
- To compare peritonitis characteristics based on community-acquired, early nosocomial, or late nosocomial settings.
- To analyze the impact of peritonitis on 90-day survival and identify associated factors.
Main Methods:
- Retrospective, multicenter cohort study of ICU patients with intra-abdominal infections (2020-2022).
- Categorization of peritonitis into community (CP), early nosocomial (ENP), and late nosocomial (LNP) settings.
- Analysis of 90-day survival using Kaplan-Meier curves and multivariable Cox regression.
Main Results:
- Low prevalence of MDROs observed: 6.1% extended-spectrum beta-lactamase-producing bacteria and 1.3% carbapenem-resistant bacteria.
- Carbapenem-resistant bacteria were more frequent in LNP (3.7%) compared to CP (0.0%) and ENP (0.5%) (p=0.03).
- Overall 90-day mortality was 34.7%, with no significant difference across peritonitis settings (p=0.345). Age and SAPS II were independent predictors of mortality.
Conclusions:
- The study identified a low prevalence of MDROs in ICU peritonitis patients.
- Findings question the routine use of broad-spectrum empirical therapy in regions with low MDRO rates.
- Tailored antimicrobial stewardship strategies are recommended for peritonitis management.
More Related Videos
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care