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CompletedNCT02442596AbSeSUpdated Jun 29, 2017

Abdominal SepsiS Study: Epidemiology of Etiology and Outcome

An observational study in Intra-Abdominal Infections, sponsored by European Society of Intensive Care Medicine. Completed at 1 site in Belgium. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2017-06-29.

Sponsored by European Society of Intensive Care Medicine · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
2,200
Ages
18 Years and older
Sex
All
01

Study summary

The aim of the project is to perform a multinational, prospective, observational study on IAIs (IntraAbdominal Infections) in critically ill patients; special emphasis will be given to epidemiology and outcomes.

Read the detailed description

To investigate microbiology and/or drug resistance patterns related to: Geographical region, Source of IAI, Upper GI tract perforation (stomach \& duodenum), Lower GI tract perforation (jejunum, ileum, colon, rectum), Primary peritonitis, Peritoneal dialysis-related peritonitis, Intra-abdominal abscess, Pancreatic infection, Biliary tract infection, Typhlitis, Toxic megacolon.

To check the Origin of IAI: community-acquired, early-onset healthcare-associated, late-onset healthcare-associated.

To describe physician's antimicrobial prescription patterns related to a classification grid that stratifies IAIs according to disease expression, community or healthcare origin, and anatomical disruption.

To investigate outcomes (clinical response, need for surgical revision, length of hospitalization, and mortality) related to: Classification of IAI, Severity of acute illness at time of diagnosis (SOFA score) and clinical response after 48-72 hrs. (SOFA score), Processes of care (Time to 1st antimicrobial dose, Time to source control, Type of source control intervention (laparotomy, percutaneous drainage, high volume peritoneal lavage, restoration of anatomy and function), Need for (unplanned) surgical revision (uncontrolled infection source), Frequency of microbiological sampling and delay of results)), Pathogens involved and empirical antimicrobial coverage; special emphasis will be given, to coverage of multidrug resistant Enterobacteriaceae, Pseudomonas aeruginosa, enterococci and Candida species, Duration of antimicrobial therapy, Underlying conditions

02

Conditions studied

  • Intra-Abdominal Infections

Keywords

  • Abdominal sepsis
  • Sepsis
  • Septic shock
  • Epidemiology
  • Etiology
  • Microbiology
  • Abdomen
  • Intra-abdominal
  • Infection
  • Gastrointestinal tract
  • Perforation
  • Peritonitis
  • Pancreas
  • Biliary tract
  • Megacolon
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

All consecutive, adult ICU patients diagnosed with IAI- intra-abdominal infection (either as a primary diagnosis or as a complication during the ICU course) during a 6 months period and with a maximum of 15 cases per unit.

Inclusion criteria

  • Adult (≥18 yrs. of age)
  • IAI treated with percutaneous or surgical procedure
  • ICU admission (the patient should either be admitted to the ICU because of abdominal sepsis or should be admitted in the ICU for other reasons and subsequently developed abdominal sepsis as a complication during the ICU course)
  • Informed consent (if required by local ethics committee)

Exclusion criteria

Exclusion Criteria:

\<18 yrs

04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
2,200 participants (actual)
Patient registry
No

Groups and cohorts

  • One Group

    This is a prospective observational study, aimed at collecting an adequate dataset on a large cohort of patients admitted to a large number of ICUs.

05

What researchers measure

Primary outcomes

  1. Clinical response

    Time frame: Clinical response at 3 days

  2. Clinical response

    Time frame: Clinical response at 7 days

Secondary outcomes

  1. Surgical revision

    For the abdominal sepsis cases that were managed with a surgical intervention (most of them), the need for a surgical revision (re-intervention) within the first week after the initial procedure is considered "failure of initial source control". The need for an additional surgical intervention within the first week will be assessed.

    Time frame: within the first week

  2. Length of hospitalization

    Length of ICU stay

    Time frame: up to 6 months

  3. Mortality

    Survival status at discharge

    Time frame: During the 6 month study period

06

Study locations

1 site
  • All Centres From All Over the World Willing to Contribute Are Welcome
    Brussels, Belgium
07

References and documents

Publications

  • Marshall JC. Intra-abdominal infections. Microbes Infect. 2004 Sep;6(11):1015-25. doi: 10.1016/j.micinf.2004.05.017. PubMed 15345234 ↗
  • De Waele JJ. Early source control in sepsis. Langenbecks Arch Surg. 2010 Jun;395(5):489-94. doi: 10.1007/s00423-010-0650-1. Epub 2010 Jun 2. PubMed 20517699 ↗
  • Schein M, Marshall J. Source control for surgical infections. World J Surg. 2004 Jul;28(7):638-45. doi: 10.1007/s00268-004-7505-2. Epub 2004 Jun 8. PubMed 15185005 ↗
  • Blot S, De Waele JJ. Critical issues in the clinical management of complicated intra-abdominal infections. Drugs. 2005;65(12):1611-20. doi: 10.2165/00003495-200565120-00002. PubMed 16060697 ↗
  • Rex JH. Candida in the peritoneum: passenger or pathogen? Crit Care Med. 2006 Mar;34(3):902-3. doi: 10.1097/01.CCM.0000202129.19154.64. No abstract available. PubMed 16505676 ↗
  • de Ruiter J, Weel J, Manusama E, Kingma WP, van der Voort PH. The epidemiology of intra-abdominal flora in critically ill patients with secondary and tertiary abdominal sepsis. Infection. 2009 Dec;37(6):522-7. doi: 10.1007/s15010-009-8249-6. PubMed 19669089 ↗
  • Swenson BR, Metzger R, Hedrick TL, McElearney ST, Evans HL, Smith RL, Chong TW, Popovsky KA, Pruett TL, Sawyer RG. Choosing antibiotics for intra-abdominal infections: what do we mean by "high risk"? Surg Infect (Larchmt). 2009 Feb;10(1):29-39. doi: 10.1089/sur.2007.041. PubMed 19226202 ↗
  • Dupont H, Friggeri A, Touzeau J, Airapetian N, Tinturier F, Lobjoie E, Lorne E, Hijazi M, Regimbeau JM, Mahjoub Y. Enterococci increase the morbidity and mortality associated with severe intra-abdominal infections in elderly patients hospitalized in the intensive care unit. J Antimicrob Chemother. 2011 Oct;66(10):2379-85. doi: 10.1093/jac/dkr308. Epub 2011 Jul 25. PubMed 21791444 ↗
  • Montravers P, Lepape A, Dubreuil L, Gauzit R, Pean Y, Benchimol D, Dupont H. Clinical and microbiological profiles of community-acquired and nosocomial intra-abdominal infections: results of the French prospective, observational EBIIA study. J Antimicrob Chemother. 2009 Apr;63(4):785-94. doi: 10.1093/jac/dkp005. Epub 2009 Feb 5. PubMed 19196742 ↗
  • Blot S, De Waele JJ, Vogelaers D. Essentials for selecting antimicrobial therapy for intra-abdominal infections. Drugs. 2012 Apr 16;72(6):e17-32. doi: 10.2165/11599800-000000000-00000. PubMed 22480338 ↗
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Registry details

Key details

Study ID
NCT02442596
Lead sponsor
European Society of Intensive Care Medicine
Responsible party
Sponsor
First posted
May 13, 2015
Start date
Jan 2016
Primary completion
Apr 1, 2017
Completion
Apr 2, 2017
Last update
Jun 29, 2017

Study contacts

Stijn BLOT
principal investigator · University Hospital Ghent, Dept. of Internal Medicine
Dirk VOGELAERS
principal investigator · University Hospital Ghent, Dept. of Internal Medicine

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jun 2017. You cannot join it, but the record below documents what was studied.

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