Update 1989 pp 141-145 | Cite as

Acquired Infections in the ICU: The Current Status of Selective Decontamination

  • G. Ramsay
  • J. Reidy
Conference paper
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 8)

Abstract

Late deaths in the intensive care unit (ICU) are virtually all due to multiple organ failure (MOF), regardless of whether the patient’s primary insult is multiple trauma, burns or postoperative sepsis. Infection is present in virtually all critically ill patients who go on to develop MOF and the incidence of acquired infection within ICUs is extremely high. Overall, infection is reported in 23–36% of patients in a general, non-specialist, ICU [1–4]. There is a high incidence of unit-acquired infection in ICU and infection rates may exceed 80% in patients admitted for 5 or more days [1, 5–7].

Keywords

Depression Penicillin Bacillus Ampicillin Vancomycin 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Thorp JM, Richards WC, Telfer ABM (1979) A survey of infection in an intensive care unit. Anaesthesia 68:457–467Google Scholar
  2. 2.
    Donowitz LG, Wenzel RP, Hoyt JW (1982) High risk of hospital acquired infection in the ICU patient. Crit Care Med 10:335–337CrossRefGoogle Scholar
  3. 3.
    Brown RB, Hosmer D, Chen HC, et al (1985) A comparison of infections in different ICUs within the same hospital. Crit Care Med 13:472–476PubMedCrossRefGoogle Scholar
  4. 4.
    Chandrasekar PM, Kruse JA, Mathews MF (1986) Nosocomial infection among patients in different types of intensive care units at a city hospital. Crit Care Med 14:508–510PubMedCrossRefGoogle Scholar
  5. 5.
    Northey D, Adess ML, Hartsuck JM, Rhoades ER (1974) Microbiologic surveillance in a surgical intensive care unit. Surg Gynecol Obstet 139:321–325PubMedGoogle Scholar
  6. 6.
    Stoutenbeek CP, van Saene HKF, Miranda DR, Zandstra DF (1984) The effect of selective decontamination of the digestive tract on colonisation and infection rate in multiple trauma patients. Intensive Care Med 10:185–192PubMedCrossRefGoogle Scholar
  7. 7.
    Ledingham IMcA, Alcock AR, Eastaway AT, McDonald JC, McKay IC, Ramsay G (1988) Triple regimen of selective decontamination of the digestive tract, systemic cefotaxime, and microbiological surveillance for prevention of acquired infection in intensive care. Lancet 1:785–790PubMedCrossRefGoogle Scholar
  8. 8.
    Christou NV, Superina R, Broadhead M, et al (1982) Post-operative depression of host resistance: determinants and effect of peripheral protein sparing therapy. Surgery 92:786–791PubMedGoogle Scholar
  9. 9.
    Watt I, Ledingham IMcA (1984) Mortality amongst multiple trauma patients admitted to an intensive therapy unit. Anaesthesia 39:973–981PubMedCrossRefGoogle Scholar
  10. 10.
    Potgeiter PD, Rosenthal E, Benatar SR (1985) Immediate and long-term survival in patients admitted to a respiratory ICU. Crit Care Med 15:495–489CrossRefGoogle Scholar
  11. 11.
    van Saene HKF, Stoutenbeek CP, Zandstra DF, Gilbertson AA, Murray A, Hart CA (1987) Nosocomial infections in severely traumatised patients: magnitude of problem, pathogenesis, prevention and therapy. Acta Anaesth Belg 38:347–353PubMedGoogle Scholar
  12. 12.
    Barza AM, Giuliano M, Jacobuc NV, Gorbach SL (1987) Effect of broad spectrum parenteral antibiotics on colonization resistance of intestinal microflora of humans. Antimicrob Agents Chemother 31:723–727PubMedGoogle Scholar
  13. 13.
    Atherton ST, White DJ (1978) Stomach as a source of bacteria colonising respiratory tract during artificial ventilation. Lancet 2:968–969PubMedCrossRefGoogle Scholar
  14. 14.
    du Moulin GC, Paterson DG, Hedley-Whyte J, Lisbon A (1982) Aspiration of gastric bacteria in antacid-treated patients: a frequent cause of postoperative colonisation in the airway. Lancet 1:242–245PubMedGoogle Scholar
  15. 15.
    Flynn DM, Weinstein RA, Nathan C, Gaston MA, Kabins SA (1987) Patients’ endogenous flora as the source of “nosocomial” Enterobacter in cardiac surgery. J Infect Dis 156:363–368PubMedCrossRefGoogle Scholar
  16. 16.
    Stoning RA, Jamieson B, McElwain TJ, et al (1977) Oral non-absorbed antibiotics prevent infection in acute nonlymphoblastic leukaemia. Lancet 2:837–840Google Scholar
  17. 17.
    van Saene HKF, Stoutenbeek CP (1987) Selective decontamination. J Antimicrob Chemother 30:462–465CrossRefGoogle Scholar
  18. 18.
    Stoutenbeek CP (1989) Prevention of MOF with SDD. In: van Saene HKF, Stoutenbeek CP, Ledingham IMcA, Lawin P (eds) Infection control in ICU by selective decontamination (Update in intensive care and emergency medicine, vol 7) Springer, Berlin Heidelberg New York Tokyo (in press)Google Scholar
  19. 19.
    Stoutenbeek CP, van Saene HKF, Zandstra DF (1987) The effect of oral nonabsorbable antibiotics on the emergence of resistant bacteria in patients in an intensive care unit. J Antiomicrob Chemother 19:513–520CrossRefGoogle Scholar
  20. 20.
    Ramsay G (1989) Endotoxaemia in multiple organ failure: a secondary role for SDD? In: van Saene HKF, Stoutenbeek CP, Ledingham IMcA, Lawin P (eds) Infection control in ICU by selective decontamination (Update in intensive care and emergency medicine, vol 7) Springer, Berlin Heidelberg New York Tokyo (in press)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • G. Ramsay
  • J. Reidy

There are no affiliations available

Personalised recommendations