intra-abdominal%20infections
INTRA-ABDOMINAL INFECTIONS
Intra-abdominal infections (IAI) occur due to disruption of the normal anatomic barrier.
In the hollow viscera is where common disruptions occur, which allows intraluminal bacteria to invade and proliferate in the usually sterile area (ie peritoneal cavity or retroperitoneum).
Community-acquired intra-abdominal infection is usually secondary to gastroduodenal perforation, ascending cholangitis, cholecystitis, appendicitis, colon diverticulitis with or without perforation, or pancreatitis.
Uncomplicated IAI infectious process involves only a single organ and does not extend to the peritoneum.
Complicated IAI is when infection extends beyond the hollow viscus of origin into the peritoneal space and may be associated with peritonitis or abscess formation.

Introduction

Intra-Abdominal Infections (IAI)

  • In hospital setting, it is the 2nd most common cause of infection that leads to severe sepsis & mortality

Pathophysiology

  • Occur due to disruption of the normal anatomic barrier
    • Hollow viscera is where common disruptions occur, which allows intraluminal bacteria to invade & proliferate in the usually sterile area (eg peritoneal cavity or retroperitoneum)

Risk Factors

Parameters Predictive of Severe/High-Risk Intra-abdominal Infections (IAI)

  • Acute physiology & chronic health evaluation-II (APACHE-II) scores ≥15
  • Advanced age
  • Poor nutritional status or low albumin levels
  • Degree of peritoneal involvement or presence of diffuse peritonitis
  • Significant cardiovascular disease or presence of other comorbidity & degree of organ dysfunction
  • Inability to achieve adequate source control
  • Immunocompromised patients (w/ cancer, inflammatory disease, or posttransplant)
  • Inadequate debridement or control of drainage
  • ≥5 days hospital stay before the operation & ≥2 days preoperative antimicrobial treatment
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Roshini Claire Anthony, 05 Oct 2017

Olfactory impairment in older adults may point to an elevated risk of developing Parkinson’s disease (PD), particularly in Caucasian men, a small US study found.

Elvira Manzano, Yesterday
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
07 Oct 2017
Women who follow a low-fat dietary pattern appear to have reduced breast cancer mortality, according to data from the Earlier Women’s Health Initiative Dietary Modification trial.
Pearl Toh, 5 days ago
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.