Summary
Generally, reduction of colonization and infection with potentially pathogenic microorganisms in intensive care units (ICU) is attempted by a combination of antimicrobial agents administered topically in the digestive tract and systematically. We tested the efficacy of topical antimicrobial prophylaxis of the oropharynx and stomach administered in combination with sucralfate without systemic prophylaxis in 25 mechanically ventilated ICU patients. The regimen successfully reduced colonization with potentially pathogenic microorganisms in the oropharynx and trachea without modifying the intestinal flora. However, colonization and infections with gram-positive cocci and gram-negative rods other thanEnterobacteriaceae andPseudomonadaceae and resistant to one or both the antimicrobial agents used were observed.
Zusammenfassung
Durch topische Anwendung einer Kombination antimikrobieller Substanzen zur Dekontamination des Gastrointestinaltraktes und systemische Antibiotikagabe wird in Intensivstationen der Versuch einer Reduktion der Kolonisation und Infektion mit potentiell pathogenen Mikroorganismen gemacht. Wir prüften die Wirksamkeit einer topischen antimikrobiellen Prophylaxe des Oropharynx und des Magens in Kombination mit Sucralfat ohne systemische Prophylaxe bei 25 beatmeten Intensivpatienten. Durch diese Maßnahme wurde die Kolonisation des Oropharynx und der Trachea mit potentiell pathogenen Keimen reduziert; die Darmflora wurde dabei nicht verändert. Allerdings war eine Kolonisation verbunden mit Infektionen durch grampositive Kokken und gramnegative Stäbchen, die nicht denEnterobacteriaceae oderPseudomonadaceae angehörten, und die gegen eine oder beide der antimikrobiellen Substanzen resistent waren, zu beobachten.
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Bonten, M.J.M., van der Geest, S., Gaillard, C.A. et al. Topical antimicrobial prophylaxis of nosocomial pneumonia in mechanically ventilated patients. Microbiological observations. Infection 21, 137–139 (1993). https://doi.org/10.1007/BF01710529
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DOI: https://doi.org/10.1007/BF01710529