Advertisement

Basics pp 215-230 | Cite as

Infection Control in Neonates and Children

  • Richard E. Sarginson
  • Hendrick K.F. van Saene
  • Antonino Gullo
Part of the Anaesthesia, Intensive Care and Pain in Neonates and Children book series (AICPNC)

Abstract

Many patients are admitted to the pediatric intensive care unit (PICU) with infection as the primary problem, for example with viral pneumonitis or meningococcal disease. Other patients are admitted free of infection but are at risk of acquisition, particularly if their stay in the PICU is prolonged with invasive devices in situ. A further group are admitted with exacerbations of chronic conditions, where infection may be a contributing factor, for example, pulmonary aspiration in a child with cerebral palsy.

Keywords

Respiratory Syncytial Virus Spinal Muscular Atrophy Surveillance Culture Selective Digestive Decontamination Selective Decontamination 
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.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Sarginson RE, Taylor N, Reilly N et al (2004) Infection in prolonged pediatric critical illness: a prospective four-year study based on knowledge of the carrier state. Crit Care Med 32:839–847CrossRefPubMedGoogle Scholar
  2. 2.
    Gastmeier P (2007) Evidence — based infection control in the ICU (except catheters). Curr Opin Crit Care 13:557–562CrossRefPubMedGoogle Scholar
  3. 3.
    Jardine M, Galvez I, Taylor N, Thorburn K et al (2007) Abnormal (resistant) flora in children with cerebral palsy requiring intensive care. Arch Dis Child 92(S1):A24Google Scholar
  4. 4.
    Bischoff WE, Wallis ML, Tucker BK et al (2006) “Gesundheit” sneezing, common colds, allergies, and Staphylococcus aureus dispersion. J Infect Dis 194(8):1119–1126CrossRefPubMedGoogle Scholar
  5. 5.
    Thorburn K, Kerr S, Taylor N, van Saene HKF (2004) RSV outbreak in a paediatric intensive care unit. J Hosp Infect 57:194–201CrossRefPubMedGoogle Scholar
  6. 6.
    Baxby D, van Saene HKF, Stoutenbeek CP, Zandstra DF (1996) Selective decontamination of the digestive tract: 13 years on, what it is and what it is not. Intensive Care Med 22:699–706CrossRefPubMedGoogle Scholar
  7. 7.
    van Saene HKF, Petros AJ, Ramsay G, Baxby D (2003) All great truths are iconoclastic: selective decontamination of the digestive tract moves from heresy to level 1 truth. Intensive Care Med 29:677–690PubMedGoogle Scholar
  8. 8.
    Liberati A, D’Amico R, Pifferi S, Torri V, Brzzi L (2004) Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database Syst Rev CD 00 00 22Google Scholar
  9. 9.
    Silvestri L, van Saene HKF, Milanese M, Gregori D, Gullo A (2007) Selective decontamination of the digestive tract reduces bacterial bloodstream infections and mortality in critically ill patients. Systematic review of randomized controlled trials. J Hosp Infect 65:187–203CrossRefPubMedGoogle Scholar
  10. 10.
    Silvestri L, van Saene HKF, Casarin A et al (2008) Impact of selective decontamination of the digestive tract on carriage and infection due to Gram-negative and Gram-positive bacteria: a systematic review of randomised controlled trials. Anaesth Intensive Care 36:324–338PubMedGoogle Scholar
  11. 11.
    Silvestri L, van Saene HKF, Milanese M et al (2005) Impact of selective decontamination of the digestive tract on fungal carriage and infection: systematic review of randomized controlled trials. Intensive Care Med 31:898–910CrossRefPubMedGoogle Scholar
  12. 12.
    Silvestri L, van Saene HKF (2008) Survival benefit of the full regimen of selective decontamination of the digestive tract (SDD). J Crit Care (in press)Google Scholar
  13. 13.
    Arnow PM, Carandang GC, Zabner R et al (1996) Randomised controlled trial of selective bowel decontamination for prevention of infections following liver transplantation. Clin Infect Dis 22:997–1003PubMedGoogle Scholar
  14. 14.
    Hellinger WC, Yao JD, Alvarez S et al (2002) A randomised, prospective, double-blind evaluation of selective bowel decontamination in liver transplantation. Transplantation 73:1904–1909CrossRefPubMedGoogle Scholar
  15. 15.
    Hammond JMJ, Potgieter PD, Saunders GL, Forder AA (1992) Double-blind study of selective decontamination of the digestive tract in intensive care. Lancet 340:5–9CrossRefPubMedGoogle Scholar
  16. 16.
    Silvestri L, van Saene HKF (2006) Selective decontamination of the digestive tract does not increase resistance in critically ill patients: evidence from randomised controlled trials. Crit Care Med 34:2027–2030CrossRefPubMedGoogle Scholar
  17. 17.
    de Jonge E, Schultz M, Spanjaard L et al (2003) Effects of selective decontamination of the digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial. Lancet 363:1011–1016Google Scholar
  18. 18.
    Barret JP, Jeschke MG, Herndon DN (2001) Selective decontamination of the digestive tract in severely burned pediatric patients. Burns 27:439–445CrossRefPubMedGoogle Scholar
  19. 19.
    Ruza F, Alvarado F, Herruzo R et al (1998) Prevention of nosocomial infection in a PICU through the use of selective digestive decontamination. Eur J Epidemiol 14:719–727CrossRefPubMedGoogle Scholar
  20. 20.
    Smith SD, Jackson RJ, Hannakan CJ et al (1993) Selective decontamination in pediatric liver transplants. A randomized prospective study. Transplantation 55:1306–1309PubMedCrossRefGoogle Scholar
  21. 21.
    Zobel G, Kuttnig M, Grubbauer HM et al (1991) Reduction of colonization and infection rate during pediatric intensive care by selective decontamination of the digestive tract. Crit Care Med 19:1242–1246CrossRefPubMedGoogle Scholar
  22. 22.
    Abecasis F, Kerr S, Sarginson RE et al (2007) Comment on: emergence of multidrug-resistant Gram-negative bacteria during selective decontamination of the digestive tract on an intensive care unit. J Antimicrob Chemother 60:445CrossRefPubMedGoogle Scholar
  23. 23.
    Gastinne H, Wolff M, de la Tour F et al (1992) A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics. N Engl J Med 326:594–599PubMedGoogle Scholar
  24. 24.
    Ferrer M, Torres A, Gonzalez J et al (1994) Utility of selective decontamination in mechanically ventilated patients. Ann Intern Med 120:389–395PubMedGoogle Scholar
  25. 25.
    Wiener J, Itokazu G, Nathan C et al (1995) A randomised, double-blind, placebo-controlled trial of selective digestive decontamination in a medical-surgical intensive care unit. Clin Infect Dis 20:861–867PubMedGoogle Scholar
  26. 26.
    Lingnau W, Berger J, Javorsky F et al (1997) Selective intestinal decontamination in multiple trauma patients: prospective, controlled trial. J Trauma 42:687–694CrossRefPubMedGoogle Scholar
  27. 27.
    Verwaest C, Verhhaegen J, Ferdinande P et al (1997) Randomized, controlled trial of selective digestive decontamination in 600 mechanically ventilated patients in a multi-disciplinary intensive care unit. Crit Care Med 25:63–71CrossRefPubMedGoogle Scholar
  28. 28.
    de la Cal MA, Cerda E, Garcia-Hierro P et al (2005) Survival benefit in critically ill burned patients receiving selective decontamination of the digestive tract. Ann Surg 241:424–430CrossRefGoogle Scholar
  29. 29.
    Thorburn K, Taylor N, Saladi SM et al (2006) Use of surveillance cultures and enteral vancomycin to control methicillin-resistant Staphylococcus aureus in a paediatric intensive care unit. Clin Microbiol Infect 12:35–42CrossRefPubMedGoogle Scholar
  30. 30.
    Silvestri L, van Saene HKF, Milanese M et al (2004) Prevention of MRSA pneumonia by oral vancomycin decontamination: a randomized trial. Eur Respir J 23:921–926CrossRefPubMedGoogle Scholar
  31. 31.
    Viviani M, van Saene HKF, Dezzoni R et al (2005) Control of imported methicillin-resistant Staphylococcus aureus (MRSA) in mechanically ventilated patients: a dose-response study of enteral vancomycin to reduce absolute carriage and infection. Anaesth Intensive Care 33:361–372PubMedGoogle Scholar
  32. 32.
    de la Cal MA, Cerda E, van Saene HKF et al (2004) Effectiveness and safety of enteral vancomycin to control endemicity of methicillin-resistant Staphylococcus aureus in a medical/surgical intensive care unit. J Hosp Infect 56:175–183CrossRefPubMedGoogle Scholar
  33. 33.
    Cerdá E, Abella A, de la Cal MA et al (2007) Enteral vancomycin controls methicillin-resistant Staphylococcus aureus endemicity in an intensive care burn unit: a 9-year prospective study. Ann Surg 245:397–407CrossRefPubMedGoogle Scholar
  34. 34.
    Bergmans DCJJ, Bonten MJM, Gaillard CA et al (2001) Prevention of ventilator associated pneumonia by oral decontamination. Am J Respir Crit Care Med 164:382–388PubMedGoogle Scholar
  35. 35.
    Gaussorgues Ph, Salard F, Sirodot M et al (1991) Nosocomial bacteremia in patients under mechanical ventilation and receiving beta-inotropic drugs: efficacy of digestive decontamination. Rean Soins Intens Med Urg 7:169–174Google Scholar
  36. 36.
    Korinek AM, Laisne MJ, Nicolas MH et al (1993) Selective decontamination of the digestive tract in neurosurgical intensive care unit patients: a double-blind, randomized, placebocontrolled study. Crit Care Med 21:1466–1473CrossRefPubMedGoogle Scholar
  37. 37.
    Krueger WA, Lenhart FP, Neeser G et al (2002) Influence of combined intravenous and topical antibiotic prophylaxis on the incidence of infections, organ dysfunctions and mortality in critically ill surgical patients. Am J Respir Crit Care Med 166:1029–1037CrossRefPubMedGoogle Scholar
  38. 38.
    Pugin J, Auckenthaler R, Lew DP, Suter PM (1991) Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia. JAMA 265:2704–2710CrossRefPubMedGoogle Scholar
  39. 39.
    Schardey HM, Joosten U, Fiuke U et al (1997) The prevention of anastomotic leakage after total gastrectomy with local decontamination. Ann Surg 225:172–180CrossRefPubMedGoogle Scholar
  40. 40.
    Morar P, Singh V, Makura Z et al (2002) Differing pathways of lower airway colonization and infection according to mode of ventilation (endotracheal vs tracheotomy). Arch Otolaryngol Head Neck Surg 128:1061–1066PubMedGoogle Scholar
  41. 41.
    Huskins WC (2007) Interventions to prevent transmission of antimicrobial-resistant bacteria in the intensive care unit. Curr Opin Crit Care 13:572–577CrossRefPubMedGoogle Scholar
  42. 42.
    Brun-Buisson C, Legrand P, Rauss A et al (1989) Intestinal decontamination for control of nosocomial multi-resistant Gram-negative bacilli. Ann Intern Med 110:873–881PubMedGoogle Scholar
  43. 43.
    van Saene HK, Taylor N, Damjanovic V, Sarginson RE (2008) Microbial gut overgrowth guarantees increased spontaneous mutation leading to polyclonality and antibiotic resistance in the critically ill. Curr Drug Target 9:419–21CrossRefGoogle Scholar
  44. 44.
    Verma N, Clarke RW, Bolton-Maggs PH, van Saene HK (2007) Gut overgrowth of vancomycinresistant enterococci (VRE) results in linezolid-resisant mutation in a child with severe congenital neutropenia: a case report. J Pediatr Hematol Oncol 29:557–560CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Richard E. Sarginson
    • 1
  • Hendrick K.F. van Saene
    • 2
  • Antonino Gullo
    • 3
  1. 1.Paediatric Intensive Care UnitRoyal Liverpool Children’s NHS Trust Alder Hey HospitalLiverpoolUK
  2. 2.Department of Medical Microbiology/Infection ControlRoyal Liverpool Children’s NHS Trust Alder Hey HospitalLiverpoolUK
  3. 3.Department of Anesthesia and Intensive Care, Postgraduate School of Anesthesia and Intensive CareCatania University HospitalCataniaItaly

Personalised recommendations