Mureșan Mircea Gabriel, Balmoș Ioan Alexandru, Badea Iudita, Santini Ario
University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureş, Târgu Mureş Romania.
Surgery Clinic No. 2, Târgu Mureş, Romania.
J Crit Care Med (Targu Mures). 2018 Oct 1;4(4):120-125. doi: 10.2478/jccm-2018-0023. eCollection 2018 Oct.
Despite the significant development and advancement in antibiotic therapy, life-threatening complication of infective diseases cause hundreds of thousands of deaths world. This paper updates some of the issues regarding the etiology and treatment of abdominal sepsis and summaries the latest guidelines as recommended by the Intra-abdominal Infection (IAI) Consensus (2017). Prognostic scores are currently used to assess the course of peritonitis. Irrespective of the initial cause, there are several measures universally accepted as contributing to an improved survival rate, with the early recognition of IAI being the critical matter in this respect. Immediate correction of fluid balance should be undertaken with the use of vasoactive agents being prescribed, if necessary, to augment and assist fluid resuscitation. The WISS study showed that mortality was significantly affected by sepsis irrespective of any medical and surgical measures. A significant issue is the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in the clinical setting, and the reported prevalence of ESBLs intra-abdominal infections has steadily increased in Asia. Europe, Latin America, Middle East, North America, and South Pacific. Abdominal cavity pathology is second only to sepsis occurring in a pulmonary site. Following IAI (2017) guidelines, antibiotic therapy should be initiated as soon as possible after a diagnosis has been verified.
尽管抗生素治疗取得了显著的发展和进步,但感染性疾病的危及生命的并发症仍在全球导致数十万人死亡。本文更新了有关腹腔感染病因和治疗的一些问题,并总结了腹腔内感染(IAI)共识(2017年)推荐的最新指南。目前使用预后评分来评估腹膜炎的病程。无论初始病因如何,有几项措施被普遍认为有助于提高生存率,其中早期识别IAI是这方面的关键问题。应立即纠正液体平衡,必要时使用血管活性药物来增强和辅助液体复苏。WISS研究表明,无论采取任何医疗和手术措施,脓毒症都会显著影响死亡率。一个重要问题是临床环境中产超广谱β-内酰胺酶(ESBL)的肠杆菌科细菌的流行情况,并且在亚洲、欧洲、拉丁美洲、中东、北美和南太平洋地区,报道的腹腔内感染中ESBLs的流行率一直在稳步上升。腹腔病理仅次于肺部发生的脓毒症。遵循IAI(2017年)指南,一旦确诊,应尽快开始抗生素治疗。