metricas
covid
Buscar en
Enfermedades Infecciosas y Microbiología Clínica
Toda la web
Inicio Enfermedades Infecciosas y Microbiología Clínica Update on intra-abdominal and post-surgical infections
Información de la revista
Vol. 26. Núm. S3.
Páginas 22-38 (abril 2008)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 26. Núm. S3.
Páginas 22-38 (abril 2008)
Monographic: “update on infectious diseases”
Acceso a texto completo
Update on intra-abdominal and post-surgical infections
Actualización sobre infecciones intraabdominales y posquirúrgicas
Visitas
2062
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,
Autor para correspondencia
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
Ver más
Este artículo ha recibido
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas

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
El Texto completo está disponible en PDF
References
[1.]
A.B. Nathens, O.D. Rotstein, J.C. Marshall.
Tertiary peritonitis: clinical features of a complex nosocomial infection.
World J Surg, 22 (1998), pp. 158-163
[2.]
M.A. Malangoni.
Evaluation and management of tertiary peritonitis.
Am Surg, 66 (2000), pp. 157-161
[3.]
M.A. Malangoni.
Current concepts in peritonitis.
Curr Gastroenterol Rep, 5 (2003), pp. 295-301
[4.]
D.H. Livingston, M.A. Malangoni.
An experimental study of susceptibility to infection after hemorrhagic shock.
Surg Gynecol Obstet, 168 (1989), pp. 138-142
[5.]
H.C. Polk Jr, A.A. Miles.
Enhancement of bacterial infection by ferric iron: kinetics, mechanisms, and surgical significance.
Surgery, 70 (1971), pp. 71-77
[6.]
M.A. Mercer-Jones, M. Heinzelmann, J.C. Peyton, et al.
The pulmonary inflammatory response to experimental fecal peritonitis: relative roles of tumor necrosis factor-alpha and endotoxin.
Inflammation, 21 (1997), pp. 401-417
[7.]
J.I. Merlino, M.A. Malangoni, C.M. Smith, et al.
Prospective randomized trials affect the outcomes of intraabdominal infection.
Ann Surg, 233 (2001), pp. 859-866
[8.]
G. Grunau, R. Heemken, T. Hau.
Predictors of outcome in patients with postoperative intra-abdominal infection.
Eur J Surg, 162 (1996), pp. 619-625
[9.]
D.H. Wittmann, M. Schein, R.E. Condon.
Management of peritonitis secondary.
Ann Surg, 224 (1996), pp. 10-18
[10.]
D.J. Wickel, W.G. Cheadle, M.A. Mercer-Jones, et al.
Poor outcome from peritonitis is caused bay disease acuity and organ failure, not recurrent peritoneal infection.
Ann Surg, 225 (1997), pp. 744-753
[11.]
J.R. Haaga.
Image-guided microsurgery.
CT and MRI of the Whole Body, pp. 2123-2257
[12.]
M.E. Cinat, S.E. Wilson, A.M. Din.
Determinants for successful percutaneous image-guided drainage of intra-abdominal abscess.
Arch Surg, 137 (2002), pp. 845-849
[13.]
D.E. Fry, R.N. Garrison, H.C. Polk Jr.
Clinical implications in Bacteroides bacteremia.
Surg Gynecol Obstet, 149 (1979), pp. 189-192
[14.]
J.D. Richardson, L.M. Flint, H.C. Polk Jr.
Peritoneal lavage. A useful diagnostic adjunct for peritonitis.
Surgery, 94 (1983), pp. 826-829
[15.]
H.C. Polk Jr.
Generalized peritonitis: a continuing challenge.
Surgery, 86 (1979), pp. 777-778
[16.]
E.H. Farthmann, U. Schoffel.
Epidemiology and pathophysiology of intraabdominal infections (IAI).
Infection, 26 (1998), pp. 329-334
[17.]
B. Lamme, M.A. Boermeester, E.J. Belt, et al.
Mortality and morbidity of planned relaparotomy versus relaparotomy on demand for secondary peritonitis.
Br J Surg, 91 (2004), pp. 1046-1054
[18.]
M.A. Malangoni, A.S. Martin.
Outcome of severe pancreatitis.
Am J Surg, 189 (2005), pp. 273-277
[19.]
S.G. Gerzof, A.H. Robbins, W.C. Johnson, et al.
Percutaneous catheter drainage of abdominal abscesses: a five year experience.
N Engl J Med, 305 (1981), pp. 653-657
[20.]
M.A. Malangoni, C.R. Shumate, H.A. Thomas, et al.
Factors influencing the treatment of intra-abdominal abscesses.
Am J Surg, 159 (1990), pp. 167-171
[21.]
J.E. Mazuski.
The surgical infection society guidelines on antimicrobial therapy for intra-abdominal infections: evidence for recommendations.
Surg Infect (Larchmt), 3 (2002), pp. 175-233
[22.]
J.S. Solomkin, J.E. Mazuski, E.J. Baron, et al.
Guidelines for the selection of anti-infective agents for complicated intra-abdominal infections.
Clin Infect Dis, 37 (2003), pp. 997-1005
[23.]
W.M. Weinstein, A.B. Onderdonk, J.G. Bartlett, et al.
Antimicrobial therapy of experimental intraabdominal sepsis.
J Infect Dis, 132 (1975), pp. 282-286
[24.]
W.G. Cheadle, D.A. Spain.
The continuing challenge of intra-abdominal infection.
Am J Surg, 186 (2003), pp. 15S-22S
[25.]
M.A. Malangoni, R.E. Condon, C.A. Spiegel.
Treatment of intra-abdominal infections is appropriate with single agent or combination antibiotic therapy.
Surgery, 98 (1985), pp. 648-655
[26.]
R.J. Burnett, D.C. Haverstock, E.P. Dellinger, et al.
Definition of the role of enterococcus in intraabdominal infection analysis of a prospective randomized trial.
Surgery, 118 (1995), pp. 716-721
[27.]
W. Steinberg, S. Tenner.
Acute pancreatitis.
N Engl J Med, 330 (1994), pp. 1198-1210
[28.]
S. Bank, P. Singh, N. Pooran, et al.
Evaluation of factors that have reduced mortality from acute pancreatitis over the past 20 years.
J Clin Gastroenterol, 35 (2002), pp. 50-60
[29.]
T.H. Baron, D.E. Morgan.
Acute necrotizing pancreatitis.
N Engl J Med, 340 (1999), pp. 1412-1417
[30.]
N.J. London, J.P. Neoptolemos, J. Lavelle, et al.
Contrast-enhanced abdominal computed tomography scanning and prediction of severity of acute pancreatitis: a prospective study.
Br J Surg, 76 (1989), pp. 268-272
[31.]
E.J. Balthazar, J.H. Ranson, D.P. Naidich, et al.
Acute pancreatitis: prognostic value of CT.
Radiology, 156 (1985), pp. 767-772
[32.]
M. Arvanitakis, M. Delhaye, V. De Maertelaere, et al.
Computed tomography and magnetic resonance imaging in the assessment of acute pancreatitis.
Gastroenterology, 126 (2004), pp. 715-723
[33.]
R. Isenmann, B. Rau, H.G. Beger.
Bacterial infection and extent of necrosis are determinants of organ failure in patients with acute necrotizing pancreatitis.
Br J Surg, 86 (1999), pp. 1020-1024
[34.]
B. Gloor, H.A. Reber.
Effects of cytokines, and other inflammatory mediators on human acute pancreatitis.
J Int Care Med, 13 (1998), pp. 305-312
[35.]
W. Uhl, H.J. Schrag, A.M. Wheatley, M.W. Bu¿chler.
The role of infection in acute pancreatitis.
Dig Surg, 11 (1994), pp. 214-219
[36.]
H.G. Beger, B. Rau, J. Mayer, U. Pralle.
Natural course of acute pancreatitis.
World J Surg, 21 (1997), pp. 130-135
[37.]
S.W. Schmid, W. Uhl, H. Friess, et al.
The role of infection in acute pancreatitis.
Gut, 45 (1999), pp. 311
[38.]
R. Golub, F. Siddiqi, D. Pohl.
Role of antibiotics in acute pancreatitis: a metaanalysis.
J Gastrointest Surg, 2 (1998), pp. 496-503
[39.]
V. Sainio, E. Kemppainen, P. Puolakkainen, et al.
Early antibiotic treatment in acute necrotising pancreatitis.
Lancet, 46 (1995), pp. 663-667
[40.]
E.L. Bradley, K. Allen.
A prospective longitudinal study of observation versus surgical intervention in the management of necrotizing pancreatitis.
Am J Surg, 161 (1991), pp. 19-25
[41.]
B. Rau, U. Pralle, W. Uhl, et al.
Management of sterile necrosis in instances of severe acute pancreatitis.
J Am Coll Surg, 181 (1995), pp. 279-288
[42.]
G. Butturini, R. Salvia, R. Bettini, M. Falconi, P. Pederzoli, C. Bassi.
Infection prevention in necrotizing pancreatitis: an old challenge with new perspectives.
Journal of Hospital Infection, 49 (2001), pp. 4-8
[43.]
S. Heinrich, M. Schäfer, V. Rousson, P.A. Clavien.
Evidence-based treatment of acute pancreatitis. A look at established paradigms.
[44.]
A.B. Nathens, J.R. Curtis, R.J. Beale, D.J. Cook, R.P. Moreno, J.A. Romand, et al.
Management of the critically ill patient with severe acute pancreatitis.
Crit Care Med, 32 (2004), pp. 2524-2536
[45.]
J.R. Haaga, D. Nakamoto.
Computed Tomography–guided Drainage of Intraabdominal Infections.
Current Infectious Disease Reports, 6 (2004), pp. 105-114
[46.]
M.E. Cinat, S.E. Wilson, A.M. Din.
Determinants for successful percutaneous image-guided drainage of intra-abdominal abscess.
Arch Surg, 137 (2002), pp. 845-849
[47.]
J.C. García, S.E. Persky, P.A. Bonis, M. Topazian.
Abscesses in Crohn's disease: outcome of medical versus surgical treatment.
J Clin Gastroenterol, 32 (2001), pp. 409-412
Copyright © 2008. Elsevier España S.L.. All rights reserved
Descargar PDF
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos