A Literature Overview of Secondary Peritonitis Due to Carbapenem-Resistant Enterobacterales (CRE) in Intensive Care Unit (ICU) Patients
Sveva Di Franco,
Aniello Alfieri,
Marco Fiore,
Ciro Fittipaldi,
Vincenzo Pota,
Francesco Coppolino,
Pasquale Sansone,
Maria Caterina Pace,
Maria Beatrice Passavanti
Affiliations
Sveva Di Franco
Department of Women, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Piazza Miraglia 2, 80138 Naples, Italy
Aniello Alfieri
Department of Postoperative Intensive Care Unit and Hyperbaric Oxygen Therapy, A.O.R.N. Antonio Cardarelli, Viale Antonio Cardarelli 9, 80131 Naples, Italy
Marco Fiore
Department of Women, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Piazza Miraglia 2, 80138 Naples, Italy
Ciro Fittipaldi
Unit of Critical Care Hospital “Ospedale Pellegrini”, Via Portamedina alla Pignasecca 41, 80134 Naples, Italy
Vincenzo Pota
Department of Women, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Piazza Miraglia 2, 80138 Naples, Italy
Francesco Coppolino
Department of Women, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Piazza Miraglia 2, 80138 Naples, Italy
Pasquale Sansone
Department of Women, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Piazza Miraglia 2, 80138 Naples, Italy
Maria Caterina Pace
Department of Women, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Piazza Miraglia 2, 80138 Naples, Italy
Maria Beatrice Passavanti
Department of Women, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Piazza Miraglia 2, 80138 Naples, Italy
This comprehensive review of the recently published literature offers an overview of a very topical and complex healthcare problem: secondary peritonitis from multidrug-resistant pathogens, especially carbapenem-resistant Enterobacterales (CRE). Spontaneous secondary peritonitis and postsurgical secondary peritonitis are among the major causes of community- and healthcare- acquired sepsis, respectively. A large number of patients enter ICUs with a diagnosis of secondary peritonitis, and a high number of them reveal infection by CRE, P. aeruginosa or A. baumannii. For this reason, we conceived the idea to create a synthetic report on this topic including updated epidemiology data, a description of CRE resistance patterns, current strategies of antimicrobial treatment, and future perspectives. From this update it is clear that antimicrobial stewardship and precision medicine are becoming essential to fight the emergence of antimicrobial resistance and that even if there are new drugs effective against CRE causing secondary peritonitis, these drugs have to be used carefully especially in empirical therapy.
