Springer TDMStijn BlotAndries Van den BergeSonia LabeauAmin LamrousJan De WaeleDylan de LangeAlexey GritsanBojan JovanovicJan GunstJan MalaskaDirk VogelaersPhilippe MontraversGuy FrancoisKoen BlotMieke DeschepperMassimo AntonelliJeffrey LipmanCecilia PereyraFernando LipovestkyDespoina KoulentiJoao Rezende-NetoYenny CardenasTomas VymazalHans Fjeldsoee-NielsenMatthias KottArvaniti KostoulaYash JaveriMassimo GirardisSharon EinavLuis Daniel Umezawa MakikadoAdam MikstackiJosé-Artur PaivaDana TomescuKumaresh VenkatesanTomislav MirkovicEmilio MasedaYalim DikmenBenedict Creagh-BrownAmin LamrousMonica EmmerichMariana CanaleLorena Silvina DietzSantiago IlutovichJohn Thomas Sanchez MiñopeRamona Baldomera SilvaMartin Alexis MontenegroPatricio MartinPablo SaulViviana ChediackGiselle SuttonRocio CouceCarina BalasiniSusana GonzalezFlorencia Maria LascarEmiliano Jorge DescotteNatalia Soledad GumielaCarina Alejandra PinoCristian CesioEmanuel ValgolioEleonora CuntoCecilia DominguezNydia Funes NelsonEsteban Martin AbegaoNorberto Christian PozoLuciana BianchiEnrique CorregerMaria Laura PastorinoErica Aurora MiyazakiNicolas GrubissichMariel GarciaNatalia BonettoNoelia Elizabeth QuevedoCristina Delia GomezFelipe QuetiLuis Gonzalez EstevarenaRuben FernandezIgnacio SantolayaSergio Hugo GrangeatJuan DogliaGraciela ZakalikCarlos PellegriniMaria Monserrat LloriaMercedes Esteban ChaconMariela FumaleMariela LeguizamonIrene Beatriz HidalgoRoberto Julian TirantiPaola CapponiAgustin TitaLuis CardonnetLisandro BettiniAgñel RamosLuciano LovesioEdith Miriam MirandaAngelica Beatriz FarfanCarina TolosaLise SeguraAdelina BellocchioBrian AlvarezAdriana ManzurRodolfo LujanNatalia FernandezNahuel ScaroneAlan ZazuCarina GrohJason FletcherJulie SmithRaman AzadNitin ChavanHelen WongMark KolLewis CampbellTherese StarrBrigit RobertsBradley WibrowTimothy WarhurstMeher ChinthamuneediBernal Buitrago FerneyMarc SimonDaniel De BackerXavier WitteboleDavid De BelsVincent CollinKarolien DamsPhilippe JorensJan De WaeleJasperina DuboisLionel HaentjensNicolas De SchryverThierry DugernierSandro RizoliPaul SantillanYi HanEwelina BiskupChangjing QuXinyu LiTao YuLu WeihuaDaniel Molano-FrancoJosé RojasJuan Mauricio Pardo OviedoDario PinillaEdgar CelisMario AriasAnita VukovicMaja VudragMatija BelavicJosip ZunicJanja KuharicIrena Bozanic KrickaIna Filipovic-GrcicBoris TomasevicMelanija ObrazBruna BodulicaMartin DohnalMilan KratochvilIgor SatinskyPeter SchwarzZdenek KosLadislav BlahutJan MacaMarek ProtusEva KieslichováLouise Gramstrup NielsenBirgitte Marianne KroghFrancisco RivadeneiraFreddy MoralesJosé MoraAlexandra Saraguro OrozcoDiego Rolando MorochoTutilloNelson Remache VargasEstuardo Salgado YepezBoris VillamaguaAdel AlsisiAbdelraouf FahmyHervé DupontSigismond LasockiCatherine Paugam-BurtzArnaud FoucrierAlexandru NicaGeneviève BarjonJihad MallatGuillaume MarcotteMarc LeoneGary DuclosPhilippe BurtinEnora AtchadeYazine MahjoubBenoît MissetJean-François Timsit2025-06-172025-06-172021-05-260012-66671179-195010.1007/s40265-021-01534-whttps://ror.circle-u.eu/handle/123456789/810485Severe intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. In this study, we report on resistance profiles of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis and Enterococcus faecium in distinct European geographic regions based on an observational cohort study on intra-abdominal infections in intensive care unit (ICU) patients. Resistance against aminopenicillins, fluoroquinolones, and third-generation cephalosporins in E. coli, K. pneumoniae and P. aeruginosa is problematic, as is carbapenem-resistance in the latter pathogen. For E. coli and K. pneumoniae, resistance is mainly an issue in Central Europe, Eastern and South-East Europe, and Southern Europe, while resistance in P. aeruginosa is additionally problematic in Western Europe. Vancomycin-resistance in E. faecalis is of lesser concern but requires vigilance in E. faecium in Central and Eastern and South-East Europe. In the subcohort of patients with secondary peritonitis presenting with either sepsis or septic shock, the appropriateness of empiric antimicrobial therapy was not associated with mortality. In contrast, failure of source control was strongly associated with mortality. The relevance of these new insights for future recommendations regarding empiric antimicrobial therapy in intra-abdominal infections is discussed.OPENCritical IllnessMicrobial Sensitivity TestsPeritonitisSeverity of Illness IndexPERITONITISENTEROBACTERIACEAEFOODDrug Resistance, Multiple, BacterialSepsisMedicine and Health SciencesHumansPharmacology (medical)FLUOROQUINOLONE RESISTANCECross InfectionMORTALITYAnti-Bacterial AgentsCommunity-Acquired InfectionsEuropeIntensive Care UnitsAnti-Bacterial Agents; Community-Acquired Infections; Critical Illness; Cross Infection; Europe; Humans; Intensive Care Units; Intraabdominal Infections; Microbial Sensitivity Tests; Peritonitis; Sepsis; Severity of Illness Index; Drug Resistance, Multiple, BacterialESCHERICHIA-COLIRISK-FACTORSIntraabdominal InfectionsKLEBSIELLA-PNEUMONIAEBLOOD-STREAM INFECTIONSPYELONEPHRITISpublication0301 basic medicine03 medical and health sciences3. Good healthdoi_dedup___:883973d1ae5b755295bf775c45fabacc340379632078.1/25934311392/247036311568/111241611591/4520851854/LU-87232522318/1792163