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The History of Selective Decontamination of the Digestive Tract

  • Hendrick K. F. van Saene
  • Hans J. Rommes
  • Durk F. Zandstra

Abstract

In the 1950s the scope of the infection problem in hospitals changed. The introduction and widespread use of chemotherapeutic and antibiotic agents resulted in profound changes in the character of infections and microorganisms that were encountered. Deaths from community-acquired infection with gram-positive pathogens such as S. pneumoniae, S. pyogenes and S. aureus became less common, while the proportion of deaths attributable to hospital-acquired infections with aerobic gram-negative bacilli (AGNB) became manifest. These so-called nosocomial infections became increasingly prevalent in that period, especially in patients whose severe underlying disease was ameliorated by improving medical therapy. Infections due to AGNB became a frequent cause of death in patients treated for leukaemia or non-Hodgkin lymphoma, renal transplantation patients and patients on mechanical ventilation. In the 1960s and 1970s the frequency of nosocomial infections continued to be a problem despite the introduction of new broad-spectrum antibiotics. It became evident that it was not hospitalisation in itself that predisposed patients to infection; rather, the hospitalised patient was an “altered host” with enhanced susceptibility to infection. Feingold [1], in 1970, described two main reasons for higher susceptibility to infection: conditions impairing cellular or humoral defence mechanisms against infection, such as leukopenia, defective function of leucocytes, Hodgkin’s disease and immunosuppressive therapy, and conditions compromising the mechanical defence barriers such as urinary and intravenous catheters, surgical wounds, burns and tracheostomy.

Keywords

Digestive Tract Surveillance Culture Selective Digestive Decontamination Selective Decontamination Endogenous Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer 2008

Authors and Affiliations

  • Hendrick K. F. van Saene
    • 1
  • Hans J. Rommes
    • 2
  • Durk F. Zandstra
    • 3
  1. 1.Department of Clinical Microbiology and Infection ControlRoyal Liverpool Children’s NHS Trust of Alder HeyLiverpoolUK
  2. 2.Department of Intensive CareGelre ZiekenhuizenApeldoornThe Netherlands
  3. 3.Department of Intensive CareOnze Lieve Vrouwe GasthuisAmsterdamThe Netherlands

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