Microbiology for the Critically Ill Patient Receiving Selective Decontamination of the Digestive Tract
Infections in critically ill patients admitted to the intensive care unit (ICU) develop mainly endogenously, and are less frequently exogenous: they are almost invariably preceded by oropharyngeal and gastrointestinal carriage of potentially pathogenic microorganisms (PPMs) . Carriage and subsequent overgrowth of PPMs in the alimentary canal are the first steps in the pathogenesis of endogenous infections; migration of PPMs into the internal organs (e.g., lower airways, bladder) may result in colonization and, eventually, infection. “Community” and “hospital” PPMs carried by the patient upon admission are the causative agents of primary endogenous infections, while “hospital” PPMs acquired by the patient during the ICU stay are responsible for secondary endogenous infections. Exogenous infections are caused mainly by hospital PPMs not carried by the patient at all .
KeywordsIntensive Care Unit Patient Carrier State Rectal Swab Surveillance Culture Selective Decontamination
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