Observational studyPloS one2019
Critically ill patients with community-onset intraabdominal infections: Influence of healthcare exposure on resistance rates and mortality.
Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
8 citing papers in PubMed.
- Antibiotics for Intra-Abdominal Infections: When, Which, How and How Long?Antibiotics (Basel, Switzerland) · 2025Review
- Unpacking the Unreliability of Interrater Reliability of Pediatric Auscultation.Hospital pediatrics · 2025Article
- Clinical Outcomes of Critically Ill Patients withJournal of fungi (Basel, Switzerland) · 2025Article
- Management of Intra-Abdominal Candidiasis in Intensive Care Setting: A Narrative Review.Journal of fungi (Basel, Switzerland) · 2025Review
- Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use.World journal of emergency surgery : WJES · 2024Review
- Critical appraisal beyond clinical guidelines for intraabdominal candidiasis.Critical care (London, England) · 2023Review
- Antibiotic-resistant microorganisms in patients with bloodstream infection of intraabdominal origin: risk factors and impact on mortality.Infection · 2021Article
- Secondary infections in mechanically ventilated patients with COVID-19: An overlooked matter?Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2021Article
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The concept of healthcare-associated infections (as opposed to hospital-acquired infections) in intraabdominal infections (IAIs) is scarcely supported by data in the literature. The aim of the present study was to analyse community-onset IAIs (non-postoperative/non-nosocomial) in patients admitted to intensive care units (ICUs), to investigate differences in resistance patterns linked to healthcare exposure and mortality-associated factors. A one-year prospective observational study (17 Spanish ICUs) was performed distributing cases as healthcare-associated infections (HCAI), community-acquired infections (CAI) and immunocompromised patients (ICP). Bacteria producing extended-spectrum β-lactamases (ESBL) and/or carbapenemase (CPE), high-level aminoglycoside- and/or methicillin- and/or vancomycin- resistance were considered antimicrobial resistant (AMR). Mortality-associated factors were identified by regression multivariate analysis. Of 345 patients included (18.8% HCAI, 6.1% ICP, 75.1% CAI), 51.6% presented generalized peritonitis; 32.5% were >75 years (55.4% among HCAI). Overall, 11.0% cases presented AMR (7.0% ESBL- and/or CPE), being significantly higher in HCAI (35.4%) vs. CAI (5.8%) (p<0.001) vs. ICP (0%) (p = 0.003). Overall 30-day mortality was 14.5%: 23.1% for HCAI and 11.6% for CAI (p = 0.016). Mortality (R2 = 0.262, p = 0.021) was positively associated with age >75 years (OR = 6.67, 95%CI = 2.56-17.36,p<0.001), Candida isolation (OR = 3.05, 95%CI = 1.18-7.87,p = 0.022), and SAPS II (per-point, OR = 1.08, 95%CI = 1.05-1.11, p<0.001) and negatively with biliary infections (OR = 0.06, 95%CI = 0.01-0.48,p = 0.008). In this study, the antimicrobial susceptibility pattern of bacteria isolated from patients with healthcare contact was shifted to resistance, suggesting the need for consideration of the healthcare category (not including hospital-acquired infections) for severe IAIs. 30-day mortality was positively related with age >75 years, severity and Candida isolation but not with AMR.
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