In the last years there has been a significant increase in the incidence of invasive infections due to Candida species. Although the epidemiological role of Candida spp. in nosocomial peritonitis is not yet defined, the clinical role is significant, because

Candida isolation is normally associated to a poor prognosis [20]. In the CIAOW Study 117 Candida isolates were collectively identified (6%). 90 were Candida albicans and 27 were non-albicans Candida. It is well known that patients with severe sepsis or septic shock may be complicated by high STI571 mortality rates. According to the CIAOW Study the overall mortality rate was 10.5% (199/1898). 29.8% of patients were admitted to the ICU in the early recovery phase immediately following surgery. In the immediate post-operative clinical period 269 patients were critically ill (132 with septic shock, 137 with CDK and cancer severe sepsis). The surgical treatment strategies following an initial emergency laparotomy have been debated in the last years. The decision whether and when to perform a relaparotomy in secondary peritonitis is largely subjective and based on professional experience. Factors indicative of progressive or persistent organ failure during early postoperative

follow-up are the best indicators for ongoing infection and associated positive findings at relaparotomy [21–23]. Relaparotomy strategies may include either a relaparotomy, when the patient’s condition demands it (“”relaparotomy on-demand”"), or a planned relaparotomy with temporarily abdomen closure Entospletinib mouse or open abdomen [24–27]. In the CIAOW Study 223 post-operative patients (11.7%) ultimately required additional surgeries. 62 (11.3%) of these patients underwent open abdominal procedures. According to univariate statistical analysis of the data, septic shock and severe sepsis Baricitinib upon hospital admission were both predictive

of patient mortality. The setting of acquisition was also a variable found to be predictive of patient mortality (healthcare-associated infections). Among the various sources of infection, colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation and post-operative infections were significantly correlated with patient mortality. Mortality rates did not vary to a statistically significant degree between patients who received adequate source control and those who did not. However, a delayed initial intervention (a delay exceeding 24 hours) was associated with an increased mortality rate. The nature of the immediate post-operative clinical period was a significant predictor of mortality. Patients requiring ICU admission were also associated with increased mortality rates. Also comorbidities were associated to patient mortality.