Abstract
Selective decontamination of the digestive tract (SDD) is probably the most investigated clinical intervention in critically ill patients treated in intensive care units (ICU). Several meta-analysis studies have been published underlining its efficacy and significance in the reduction of infections in the critically ill patient, especially of ventilator-associated pneumonia (VAP) and bloodstream infections with consequent reductions of mortality by 20% [1]–[3].
Chapter PDF
Similar content being viewed by others
Keywords
- Antimicrobial Resistance
- Selective Digestive Decontamination
- Selective Decontamination
- Protected Specimen Brush
- 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
D’Amico R, Pifferi S, Leonetti C et al (1998) Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials. BMJ 316:1275–1285
Nathens AB, Marshall JC (1999) Selective decontamination of the digestive tract in surgical patients: a systematic review of the evidence. Arch Surg 134: 170–176
Heyland DK, Cook DJ, Jaeschke R et al (1994) Selective decontamination of the digestive tract. An overview. Chest 105:1221–1229
Stoutenbeek CP, van Saene HKF, Miranda DR et al (1987) The effect of oropharyngeal decontamination using topical non-absorbable antibiotics on the incidence of nosocomial respiratory infections in multiple trauma patients. J Trauma 27:357–364
Baxby D, van Saene HKF, 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 22:699–706
Fridkin SK, Gaynes RP (1999) Antimicrobial resistance in intensive care units. Clin Chest Med 20:303–316
Toltzis Ph, Yamashita T, Vilt L et al (1997) Colonization with antibiotic Gram-negative organisms in a paediatric intensive care unit. Crit Care Med 25:538–544
Garrouste-Orgeas M, Marie O, Rouveau M et al (1996) Secondary carriage with multiresistant Acinetobacter baumannii and Klebsiella pneumoniae in an adult ICU population: relationship with nosocomial infections and mortality. J Hosp Infect 34: 279–289
Johanson WG, Pierce AK, Sanford JP (1969) Changing pharyngeal bacterial flora of hospitalized patients. Emergence of gram-negative bacilli. N Engl J Med 281:1137–1140
Van Saene HKF, Stoutenbeek CP, Geitz JN et al (1988) Effect of amoxycillin on ‘colonisation resistance’ in human volunteers. Microb Ecol Health Dis 1:169–177
Mobbs KJ, van Saene HKF, Sunderland D et al (1999) Oropharyngeal Gram-negative bacillary carriage. Chest 115:1570–1575
Mackowiak PA, Martin RM, Jones SR et al (1978) Pharyngeal colonisation by Gram-negative bacilli in aspiration prone persons. Arch Intern Med 138:1224–1227
Fuxench-Lopez Z, Ramirez-Ronda CH (1978) Pharyngeal flora in ambulatory alcoholic patients. Arch Intern Med 138:1815–1816
Mobbs KJ, van Saene HKF, Sunderland D et al (1999) Oropharyngeal Gram-negative bacillary carriage in chronic obstructive pulmonary disease: relation to severity of disease. Respir Med 93:540–545
Morris JG, Shay DK, Hebden JN et al (1995) Enterococci resistant to multiple antimicrobial agents, including vancomycin. Ann Intern Med 123:250–259
Coque TM, Tomayko JF, Ricke SC et al (1996) Vancomycin-resistant enterococci from nosocomial, community and animal sources in the United States. Antimicrob Agents Chemother 40:2605–2609
Pujol M, Pena C, Pallares R et al (1996) Nosocomial Staphylococcus aureus bacteremia among nasal carriers of methicillin-resistant and methicillin-susceptible strains. Am J Med 100:509–516
Sanchez-Garcia M, Cambronero-Galache JA, Lopez-Diaz J et al (1998) Effectiveness and costs of selective decontamination of the digestive tract in critically ill intubated patients. Am J Respir Crit Care Med 158:908–916
van der Voort PH, van der Hulst RW, Zandstra DF et al (2001) Suppression of Helicobacter pylori infection during intensive care stay: related to stress ulcer bleeding incidence? J Crit Care 16:182–187
Daschner FD, Frey P, Wolff G et al (1982) Nosocomial infections in intensive care wards: a multicenter prospective study. Intensive Care Med 8:5–9
Rangel-Frausto MS, Pittet D, Costigan M et al (1995) The natural history of the systemic inflammatory response syndrome (SIRS): a prospective study. JAMA 273:117–123
Source: Algemeen Nederlands Persbureau.
Fagon JY, Chastre J, Wolff M et al (2000) Invasive and non-invasive strategies for management of suspected ventilator-associated pneumonia. Ann Intern Med 132:621–630
Canadian Critical Care Trials Group; Heyland D, Dodek P, Muscedere J et al (2006) A randomized trial of diagnostic techniques for ventilator-associated pneumonia. N Engl J Med 355:2619–2630
de Man P, Verhoeven BA, Verbrugh HA et al (2000) An antibiotic policy to prevent emergence of resistant bacilli: Lancet 355:973–978
Wolff M (1998) Comparison of strategies using cefpirome and ceftazidime for empiric treatment of pneumonia in intensive care patients. The Cefpirome Pneumonia treatment group Antimicrob Agents Chemother 42:28–36
Brun-Buisson C, Sollet JP, Schweich H et al (1998) Treatment of ventilator-associated pneumonia with piperacillin-tazobactam/amikacin versus ceftazidime/amikacin: a multicenter, randomized controlled trial. VAP Study Group. Clin Infect Dis 26:346–354
Beaucaire G, Nicolas MH, Martin C (1999) Phare study. Comparative study of combined cefepime-amikacin versus ceftazidime combined with amikacin in the treatment of nosocomial pneumonias in ventilated patients. Multicenter group study. Ann Fr Anesth Reanim 18:186–195
Klein BS, Perloff WH, Maki DG (1989) Reduction of nosocomial infection during pediatric intensive care by protective isolation. N Engl J Med 320:1714–1721
van der Waaij D, van der Waaij JM (1985) Spread of multiresistant gram-negative bacilli among severely immuno-compromised mice during prophylactic treatment with different oral antimicrobial drugs. Prog Clin Biol Res 181:245–250
Baines PB, Taylor N, Sarginson RE et al. (2006) Emergence of antimicrobial resistance in a paediatric intensive care unit (PICU). Pediatr Crit Care Med Suppl 3rd World Congress, book of Abstracts, 165 FP16 Infectious Diseases.
de la Cal MA, Cerda E, Calderon M et al. Oral vancomycin in the control of MRSA outbreaks in ICU. In: van Saene HKF, Sganga G, Silvestri L (eds) Infection in the critically ill: an ongoing challenge. Springer-Verlag Italia, Milan 2001, pp 139–146
Hammond JMJ, Potgieter PD (1995) Long-term effects of selective decontamination on antimicrobial resistance. Crit Care Med 23:637–645
Stoutenbeek CP, van Saene HKF, Zandstra DF (1987) The effect of oral non-absorbable antibiotics on the emergence of resistant bacteria in patients in an intensive care unit. J Antimicrob Chemother 19:513–520
Lingnau W, Berger J, Javorsky F et al (1998) Changing bacterial ecology during a five-year period of selective intestinal decontamination. J Hosp Infect 39:195–206
van der Voort PHJ, van Roon EN, Kampinga GA et al (2004) A before-after study of multi-resistance and cost of selective decontamination of the digestive tract. Infection 32:271–277
Viviani M, van Saene HK, Dezzoni R et al (2005) Control of imported and acquired 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 33:361–372
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 32:839–842
Heininger A, Meyer E, Schwab F et al (2006) Effects of long-term routine use of selective digestive decontamination on antimicrobial resistance. Intensive Care Med 32:1569–1576
Leone M, Albanese J, Antonini F et al (2003) Long-term (6 year) effect of selective digestive decontamination on antimicrobial resistance in intensive care, multiple-trauma patients. Crit Care Med 31:2090–2095
De la Cal MA, Cerda E, van Saene HK 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 56:175–183
Cerda 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 245:397–407
Tetteroo GWM, Wagenvoort JHT, Bruining HA (1994) Bacteriology of selective decontamination: efficacy and rebound colonization. J Antimicrob Chemother 34:529–544
Saunders N, Hammond JMJ, Potgieter PD et al (1994) Microbiological surveillance during selective decontamination of the digestive tract (SDD). J Antimicrob Chemother 34:529–544
Silvestri L, van Saene HK (2006) Selective decontamination of the digestive tract does not increase resistance in critically ill patients: evidence from randomized controlled trials. Crit Care Med 34:2027–2029
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(9389):1011–1016
Brun-Buisson C, Legrand P, Rauss A et al (1989) Intestinal decontamination for control of nosocomial multi-resistant-gram-negative bacilli. Ann Intern Med 110:873–881
Damjanovic V, van Saene HK (2005) Microbial mutation as a source of polyclonality in the gut of the critically ill. J Hosp Infect 59:374–375
Taylor ME, Oppenheim BA (1991) Selective decontamination of the gastrointestinal tract as an infection control measure. J Hosp Infect 71:271–278
Agusti C, Pujol M, Argerich MJ et al (2002) Short-term effect of the application of selective decontamination of the digestive tract on different body site reservoir ICU patients colonized by multi-resistant Acinetobacter baumannii. J Antimicrob Chemother 49:205–208
Al Naiemi N, Heddema ER, Bart A et al (2006) Emergence of multidrug-resistant Gramnegative bacteria during selective decontamination of the digestive tract on an intensive care unit. J Antimicrob Chemother 58:853–856
Gastinne H, Wolff M, Delatour F et al (1992) A controlled trial in intensive care units of selective decontamination of the digestive tract with non-absorbable antibiotics. N Engl J Med 326:594–599
Hammond JM, Potgieter PD, Saunders GL et al (1992) Double-blind study of selective decontamination of the digestive tract in intensive care. Lancet 340:5–9
Ferrer M, Torres A, Gonzalez J et al (1994) Utility of selective digestive decontamination in mechanically ventilated patients. Ann Intern Med 120:389–395
Wiener J, Itokazu G, Nathan C et al (1995) A randomized, double-blind, placebo controlled trial of selective digestive decontamination in a medical, surgical intensive care unit. Clin Infect Dis 20:861–867
Lingnau W, Berger J, Javorsky F et al (1997) Selective intestinal decontamination in multiple trauma patients: prospective, controlled trial. J Trauma 42:687–694
Verwaest C, Verhaegen 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 25:63–71
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: a randomized, placebocontrolled, double-blind trial. Ann Surg 241:424–430
Silvestri L, van Saene HK, Milanese M et al (2004) Prevention of MRSA pneumonia by oral vancomycin decontamination: a randomised trial. Eur Respir J 23:921–926
Geraci JE, Heilman FR, Nichols DR et al (1956) Some laboratory and clinical experiences with a new antibiotic, vancomycin. Mayo Clin Proc 31:564–582
Currie BP, Lemos-Filho L (2004) Evidence for biliary excretion of vancomycin into stool during intravenous therapy: potential implications for rectal colonization with vancomycin-resistant enterococci. Antimicrob Agents Chemother 48:4427–4429
Tedesco F, Markham R, Gurwith M et al (1978) Oral vancomycin for antibiotic-associated pseudomembranous colitis. Lancet II/8083:226–228
Arnow PM, Carandang GC, Zabner R et al (1996) Randomized controlled trial of selective bowel decontamination for prevention of infections following liver transplantation. Clin Infect Dis 22:997–1003
Hellinger WC, Yao JD, Alvarez S et al (2002) A randomized, prospective, double-blinded evaluation of selective bowel decontamination in liver transplantation. Transplantation 73:1904–1909
Bergmans DC, Bonten MJ, Gaillard CA et al (2001) Prevention of ventilator-associated pneumonia by oral decontamination: a prospective, randomized, double-blind, placebo-controlled study. Am J Respir Crit Care Med 164:382–388
Gaussorgues P, Salord F, Sirodot M et al (1991) Efficacité de la décontamination digestive sur la survenue des bactériémies nosocomiales chez les patients sous ventilation méchanique et recevant des betamimétiques. Réanimation Soins Intensifs Médecin d’Urgence 7:169–174
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 21:1466–1473
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: a prospective, stratified, randomized, double-blind, placebo-controlled clinical trial. Am J Respir Crit Care Med 166:1029–1037
Pugin J, Auckenthaler R, Lew DP et al (1991) Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia. A randomized, placebo-controlled, doubleblind clinical trial. JAMA 265:2704–2710
Schardey HM, Joosten U, Finke U et al (1997) The prevention of anastomotic leakage after total gastrectomy with local decontamination. A prospective, randomized, double-blind, placebo-controlled multicenter trial. Ann Surg 225:172–180
Sanchez M, Mir N, Canton R, Luque R et al (1997) The effect of topical vancomycin on acquisition, carriage and infection with methicillin-resistant Staphylococcus aureus in critically ill patients. A double-blind, randomised, placebo-controlled study. 37th ICAAC, 1997, Toronto, Canada, Abstract J-119, p. 310
Stiefel U, Paterson DL, Pultz NJ et al (2004) Effect of the increasing use of piperacillin/tazobactam on the incidence of vancomycin-resistant enterococci in four academic medical centers. Infect Control Hosp Epidemiol 25:380–383
Salgado CD, Gianetta ET, Farr BM (2004) Failure to develop vancomycin-resistant enterococci in San Francisco Bay area hospitals during 1994 to 1998. Infect Control Hosp Epidemiol 25:413–417
Hendrix CW, Hammond JMJ, Swoboda SM et al (2001) Surveillance strategies and impact of vancomycin-resistant enterococcal colonisation and infection in critically ill patients. Ann Surg 233:259–265
Slaughter S, Hayden MK, Nathan C et al (1996) A comparison of the effect of universal use of gloves and gowns with that of glove alone on acquisition of vancomycin resistant enterococci in a medical intensive care unit. Ann Intern Med 125:448–456
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer
About this chapter
Cite this chapter
Zandstra, D.F., van Saene, H.K.F., van der Voort, P.H.J. (2008). Antimicrobial Resistance During 20 Years of Clinical SDD Research. In: van der Voort, P.H.J., van Saene, H.K.F. (eds) Selective Digestive Tract Decontamination in Intensive Care Medicine: a Practical Guide to Controlling Infection. Springer, Milano. https://doi.org/10.1007/978-88-470-0653-9_9
Download citation
DOI: https://doi.org/10.1007/978-88-470-0653-9_9
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-0652-2
Online ISBN: 978-88-470-0653-9
eBook Packages: MedicineMedicine (R0)