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Inicio Enfermedades Infecciosas y Microbiología Clínica Update on intra-abdominal and post-surgical infections
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Vol. 26. Issue S3.
Pages 22-38 (April 2008)
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Vol. 26. Issue S3.
Pages 22-38 (April 2008)
Monographic: “update on infectious diseases”
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Update on intra-abdominal and post-surgical infections
Actualización sobre infecciones intraabdominales y posquirúrgicas
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Miguel Salaverta, José María Aguadob, Ángel Asensioc, José Barberánd, Juan de Dios Colmeneroe, José Elías García-Sánchezf, Javier Guiraog, José Hernández-Queroh, Josefina Liñaresi, Pedro Llinaresj, Pilar Marcok, Emilio Masedal, Joaquín Portillam, Alejandro Sorianon, Evaristo Varoo, Julián Torre-Cisnerosp,
Corresponding author
julian.torre.sspa@juntadeandalucia.es

Correspondence: Dr. J. Torre-Cisneros. UGC de Enfermedades Infecciosas. Hospital Universitario Reina Sofía. Avda. Menéndez Pidal, s/n. 14004 Córdoba. Spain.
a Hospital Universitario La Fe. Valencia. Spain
b Hospital Universitario 12 de Octubre. Madrid. Spain
c Hospital Puerta de Hierro. Madrid. Spain
d Hospital Central de la Defensa. Madrid. Spain
e Hospital Universitario Carlos Haya. Málaga. Spain
f Hospital Clínico. Salamanca. Spain
g Hospital de Figueres. Girona. Spain
h Hospital Universitario San Cecilio. Granada. Spain
i Hospital Universitario de Bellvitge. Barcelona. Spain
j Hospital Universitario Juan Canalejo. A Coruña. Spain
k Hospital Nuestra Señora de Aránzazu. San Sebastián. Spain
l Hospital Universitario La Paz. Madrid. Spain
m Hospital General Universitario. Alicante. Spain
n Hospital Clínic. Barcelona. Spain
o Complejo Hospitalario Universitario de Santiago. Santiago de Compostela. A Coruña. Spain
p Hospital Universitario Reina Sofía. Córdoba. Spain
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The present article is an update of the literature on intra-abdominal infection, which represents a spectrum of diseases with a common pathogenesis. Establishing a prompt diagnosis and avoiding treatment delays are key to achieving the best outcomes. Mortality depends on initiating early appropriate treatment to restore fluid and electrolyte imbalances, supporting the function of vital organs, providing appropriate broad-spectrum antimicrobial therapy, and achieving adequate source control.

A multidisciplinary group of Spanish physicians with an interest in these infections selected the most important papers produced in the field during 2005 and 2006.

One of the members of the group discussed the content of each of the selected papers, with a critical review by other members of the panel.

After a review of the state of the art, papers from the fields of epidemiology, pathophysiology, basic science, causative microorganisms and microbiological diagnosis, main clinical syndromes, principles of therapy, new antibiotics and surgical procedures, preventive measures, recommended antimicrobial regimens and guidelines were discussed by the group. Faculty from this panel have made an interesting contribution to our understanding and management of intra-abdominal infections at present. Their contribution is particularly relevant for clinical practice.

Key words:
Intraabdominal infections
Peritonitis
Pancreatitis
Biliary tract infections
Early post-transplantation infections
Epidemiology
Pathophysiology
Microbiological diagnosis
Organ failure
Source control
Antibiotic therapy
Prevention
Guidelines

El presente artículo es una puesta al día de la literatura sobre infecciones intraabdominales, que constituyen una gama de procesos con una patogenia común. Para lograr los mejores resultados tiene una importancia decisiva establecer un diagnóstico precoz y evitar los retrasos en el tratamiento. La reducción de la mortalidad se basa en iniciar precozmente un tratamiento apropiado para restaurar los desequilibrios hidroelectrolíticos, en apoyar la función de los órganos vitales, en proporcionar un tratamiento adecuado con antibióticos de amplio espectro y en controlar correctamente las fuentes de la infección. Un grupo multidisciplinario de médicos españoles interesados en este campo seleccionó los trabajos más destacados que se han publicado sobre el tema en 2005 y 2006. Cada artículo seleccionado fue analizado por un miembro del panel, y el resto de miembros efectuó una revisión crítica.

Después de revisar el estado del arte, el grupo discutió los trabajos sobre epidemiología, fisiopatología, ciencias básicas, microorganismos causales y diagnóstico bacteriológico, principales síndromes clínicos, fundamentos del tratamiento, nuevos antibióticos y procedimientos quirúrgicos, medidas preventivas, y pautas y normas antimicrobianas recomendadas. Los miembros de este panel han aportado una interesante contribución a nuestros conocimientos y a la conducta a seguir actualmente ante las infecciones intraabdominales. Su contribución es especialmente relevante para la práctica clínica.

Palabras clave:
Infecciones intraabdominales
Peritonitis
Pancreatitis
Infecciones del tracto biliar
Infecciones precoces postrasplante
Epidemiología
Fisiopatología
Diagnóstico bacteriológico
Fallo orgánico
Control de la fuente
Tratamiento antibiótico
Prevención
Normas
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Copyright © 2008. Elsevier España S.L.. All rights reserved
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