Advertisement

Pathophysiology of Resistance amongst Aerobic Gram-negative Bacilli in Particular Acinetobacter Species

  • N. Taylor
  • L. Silvestri
  • H. K. F. van Saene
Conference paper

Abstract

Selective decontamination of the digestive tract (SDD) is an antimicrobial prophylaxis consisting of parenteral cefotaxime and enteral and topical polymyxin E/tobramycin/amphotericin B (PTA). SDD prevents severe endogenous and exogenous infections of lower airways and blood and reduces mortality in the critically ill requiring treatment in the intensive care unit (ICU) [1].

Keywords

Intensive Care Unit Simplified Acute Physiological Score Resistant Microorganism Intensive Care Unit Treatment Abnormal Flora 
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.

References

  1. 1.
    Gullo A (ed) (2009) Intensive and critical care medicinc, WFSICCM congress Firenze. Springer Milan, pp 273–283CrossRefGoogle Scholar
  2. 2.
    Viviani M, van Saenc HK, Pisa F et al (2010) The role of admission surveillance cultures in patients requiring prolonged mechanical ventilation in the intensive care unit. Anaesthesia Intens Care 38: 325–335Google Scholar
  3. 3.
    Garrouste-Orgcas M, Marie O, Rouveau M et al (1996) Secondary carriage with multiresistant Acinctobactcr baumannii and Klebsiella pneumoniae in an adult ICU population: relationship with nosocomial infections and mortality. J Hosp Infect 34: 279–289CrossRefGoogle Scholar
  4. 4.
    Hammond J M, Fotgietcr FD, Saunders GL, Forder AA(1992) Double-blind study of selective decontamination of the digestive tract in intensive care. Lancet 340: 5–9PubMedCrossRefGoogle Scholar
  5. 5.
    Silvestri L, Petros AJ, Sarginson RE ct al (2005) Handwashing in the intensive care unit: a big measure with modest effects. J Hosp Infect 59: 172–179PubMedCrossRefGoogle Scholar
  6. 6.
    D’gata EM, Thayer V, Schaffner W (2000) An outbreak of Acinctobacter baumannii: the importance of cross-transmission. Infect Control Hosp Epidemiol 21: 588–591PubMedCrossRefGoogle Scholar
  7. 7.
    Edwards J, Fatcl G, Wareham DW (2007) Low concentrations of commercial alcohol hand rubs facilitate growth of and secretion of extracellular proteins by multidrugresistant strains of Acinctobactcr baumannii. J Med Microbiol 56: 1595–1599PubMedCrossRefGoogle Scholar
  8. 8.
    Van Ufielen R. van Saene H K, Fidler V, Löwenberg A (1984) Oropharyngeal flora as a source of bacteria colonizing the lower airways in patients on artificial ventilation. I CM 10: 233–237Google Scholar
  9. 9.
    Deitch EA, Xu DZ, Qi L, Berg RD (1991) Bacterial translocation from the gut impairs systemic immunity. Surgery 104: 269–276Google Scholar
  10. 10.
    Baue AE (1993) The role of the gut in the development of multiple organ dysfunction in cardiothoracic patients. Ann Thoracic Surg 55: 822–829CrossRefGoogle Scholar
  11. 11.
    van Saene HKJ, Taylor N, Damjanovic V et al (2008) Microbial gut overgrowth guarantees increased spontaneous mutation leading to polyclonality and antibiotic resistance in the critically ill. Curr Drug Targ 9: 419–421CrossRefGoogle Scholar
  12. 12.
    Vandenbrouckc-Grauls CM, Vandenbroucke JF (1991) Effect of selective decontamination of the digestive tract on respiratory tract infections and mortality in the intensive care unit. Lancet 338: 859–862CrossRefGoogle Scholar
  13. 13.
    D’Amico R, Fiffcri S, Leonetti C, on behalf of the Study Investigators (1998) Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials. BMJ 316: 1275–1285PubMedCrossRefGoogle Scholar
  14. 14.
    Safdar N, Said A, Lucey MR (2004) The role of selective decontamination for reducing infection in patients undergoing liver transplantation: a systematic review and meta-analysis. Liver Transpl 10: 817–827PubMedCrossRefGoogle Scholar
  15. 15.
    Liberati A, D’Amico R, Pifferi S et al (2004) Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care (Cochrane Review). In: The Cochrane Library Issue 1, 2004, John Wiley & Sons, ChichesterGoogle Scholar
  16. 16.
    Silvestri L, van Saene HKF, Milanese M, Gregori D (2005) Impact of selective decontamination of the digestive tract on fungal carriage and infection: systematic review of randomized controlled trials. Intensive Care Med 31: 898–910PubMedCrossRefGoogle Scholar
  17. 17.
    Silvestri L, van Saene HKF, Milanese M et al (2007) Selective decontamination of the digestive tract reduces bloodstream infections and mortality in critically ill patients: a systematic review of randomized controlled trials. J Hosp Infect 65: 187–203PubMedCrossRefGoogle Scholar
  18. 18.
    Silvestri L, van Saene HKF, Casarin AL et al (2008) Impact of selective decontamination of the digestive tract on carriage and infection due to Gram-negative and Gram-positive bacteria. Systematic review of randomized controlled trials. Anaesths Intens Care 36: 324–338Google Scholar
  19. 19.
    Silvestri L, van Saene HKF, Weir I, Gullo A (2009) Survival benefit of the full selective digestive decontamination regimen. J Crit Care 24: 474. e7–e14PubMedGoogle Scholar
  20. 20.
    Liberati A, D’Amico R, Pifferi S et al (2009) Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database Syst Rev CD000022Google Scholar
  21. 21.
    Silvestri L, van Saene HK, Zandstra DF et al (2010) Selective decontamination of the digestive tract reduces multiple organ failure and mortality in critically ill patients: systematic review of randomized controlled trials. Crit Care Med 38: 1370–1376PubMedGoogle Scholar
  22. 22.
    Silvestri L, van Saene HK, Zandstra DF (2010) Selective digestive decontamination reduces ventilator-associated tracheobronchitis. Respir Med 104: 325–336CrossRefGoogle Scholar
  23. 23.
    Baxby D, van Saene HK, Stoutenbeek CP et al (1996) Selective decontamination of the digestive tract: 13 years on, what it is and what it is not. Intensive Care Med 22: 699–706PubMedCrossRefGoogle Scholar
  24. 24.
    Laupland KB, Fisman DN (2009) Selective digestive tract decontamination: A tough pill to swallow. Can J Infect Dis Med Microbiol 20: 9–11Google Scholar
  25. 25.
    Verma N, Clarke RW, Bolton-Maggs PH et al (2007) Gut overgrowth of vancomycin-resistant enterococci ( VRE) results in linezolid-resistant mutation in a child with severe congenital neutropenia. J Pediatr Hematol Oncol 29: 557–560PubMedCrossRefGoogle Scholar
  26. 26.
    Kohanski MA, DePristo MA, Collins JJ (2010) Sublethal antibiotic treatment leads to multidrug resistance via radical-induced mutagenesis. Molecular Cell 37: 311–320PubMedCrossRefGoogle Scholar
  27. 27.
    Juan C, Gutierrez O, Oliver A et al (2005) Contribution of clonal dissemination and selection of mutants during therapy to Pseudomonas aeruginosa antimicrobial resistance in an intensive care unit setting. Clin Microbiol Infect 11: 887–892PubMedCrossRefGoogle Scholar
  28. 28.
    de Jonge E, Schultz MJ, Spanjaard L et al (2003) Effects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial. Lancet 362: 1011–1016PubMedCrossRefGoogle Scholar
  29. 29.
    de Smet AM, Kluytmans JA, Cooper BS et al (2009) Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med 360: 20–31PubMedCrossRefGoogle Scholar
  30. 30.
    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: 445PubMedCrossRefGoogle Scholar
  31. 31.
    Bodey GP (1981) Antibiotic prophylaxis in cancer patients: regimens of oral nonabsorbable antibiotics for prevention of infection during induction of admission. Rev Infect Dis 3 (Suppl): S259–S268PubMedGoogle Scholar
  32. 32.
    Brun-Buisson C, Legrand P, Rauss A et al (1989) Intestinal decontamination for control of nosocomial multiresistant gram-negative bacilli. Study of an outbreak in an intensive care unit. Ann Intern Med 110: 873–881PubMedGoogle Scholar
  33. 33.
    Flaherty J, Nathan C, Kabins SA, Weinstein RA (1990) Pilot trial of selective decontamination for prevention of bacterial infection in an intensive care unit. J Infect Dis 162: 1393–1397PubMedCrossRefGoogle Scholar
  34. 34.
    Laggner AN, Tryba M, Georgopoulos A et al (1994) Oropharyngeal decontamination with gentamicin for long-term ventilated patients on stress ulcer prophylaxis with sucralfate? Wien Klin Wochenschr 106: 15–19PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • N. Taylor
  • L. Silvestri
  • H. K. F. van Saene

There are no affiliations available

Personalised recommendations