Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

Abstract

The CIAO Study (“Complicated Intra-Abdominal infection Observational” Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012).Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study.2,152 patients with a mean age of 53.8 years (range: 4–98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified.The overall mortality rate was 7.5% (163/2.152).According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission.Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe.

Preoperative prognostic factors for severe diffuse secondary peritonitis: a retrospective study

“…In a recent large Complex IntraAbdominal infection Observational (CIAO) study from Europe [22], the mortality for patients with severe sepsis or septic shock at admission was 32 %, which is comparable to this study.…”

Phase 2, Randomized, Double-Blind Study of the Efficacy and Safety of Two Dose Regimens of Eravacycline versus Ertapenem for Adult Community-Acquired Complicated Intra-Abdominal Infections

“…In this study, the most common baseline pathogens were Escherichia coli, Klebsiella spp., streptococci, enterococci, and Bacteroides spp., consistent with those associated typically with cIAI, although the recovery of anaerobic pathogens was lower in the present study than in some recent reports (20,21). These pathogens were eradicated at similar rates by both study drugs.…”

Antibiotic resistance pattern and clinical outcomes in acute cholecystitis: 567 consecutive worldwide patients in a prospective cohort study

“…Moreover, the data coming from the CIAOW study supported effective empirical M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 6 antimicrobial therapy. An ineffective therapy led to three-fold increase in bacterial resistances [4,23] Our study showed that 44.8% of patients with AC presented with sepsis, 5.8% with severe sepsis and 2.8% with septic shock. Thus, more than half of the patients with AC were critical at presentation, stressing the necessity to initiate timely and effective empirical antibiotic therapy.…”