Guidelines
Intra-abdominal Infection

Intra-abdominal Infection

Definitions

  • Infectious process only involves a single organ and no anatomical disruption is present
  • Generally, patients can be managed with surgical resection alone and no antimicrobial therapy besides perioperative prophylaxis is necessary
  • Infectious process proceeds beyond the organ that is the source of the infection
  • Causes either localized peritonitis (often referred to as abdominal abscess) or diffuse peritonitis, depending on the ability of the host to contain the process within a part of the abdominal cavity
  • Usually requires an invasive surgical procedure for source control
  • Involve conditions such as gastroduodenal perforation, ascending cholangitis, cholecystitis, appendicitis or diverticulitis with or without perforation, and pancreatitis without previous surgical intervention or hospitalization
  • Infectious process that is absent at the time of hospital admission, but becomes evident at ≥ 48h after admission
  • Includes anastomotic leaks and perforations as well as abscesses that develop as a complication of surgery
  • Also includes infections acquired during the course of receiving treatment for other conditions in a health care setting, including the nursing home, dialysis unit or surgical day care, within the previous 12 months.

Severity of Illness: Acute Physiology and Chronic Health Evaluation II (APACHEII)

Score < 15: Low-moderate Severity

Score ≥ 15: High Severity

Community acquired surgical intra-abdominal infections with low-moderate severity (APACHE II score < 15)

Health-care associated surgical IAIs OR Severely ill patients (APACHE II score ≥ 15) with community acquired infections

More Information

  • Chow, A., Evans, G., Nathens, A., Ball, C., Hansen, G., Harding, G., Kirkpatrick, A., Weiss, K., Zhanel, G. AMMI Canadian Guidelines. Canadian practice guidelines for surgical intra-abdominal infections. Can J infect Dis Med Microbiol 21(1): 11-37.