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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2014

Open Access 01-12-2014 | Research article

Topical antibiotics as a major contextual hazard toward bacteremia within selective digestive decontamination studies: a meta-analysis

Author: James C Hurley

Published in: BMC Infectious Diseases | Issue 1/2014

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Abstract

Background

Among methods for preventing pneumonia and possibly also bacteremia in intensive care unit (ICU) patients, Selective Digestive Decontamination (SDD) appears most effective within randomized concurrent controlled trials (RCCT’s) although more recent trials have been cluster randomized. However, of the SDD components, whether protocolized parenteral antibiotic prophylaxis (PPAP) is required, and whether the topical antibiotic actually presents a contextual hazard, remain unresolved. The objective here is to compare the bacteremia rates and patterns of isolates in SDD-RCCT’s versus the broader evidence base.

Methods

Bacteremia incidence proportion data were extracted from component (control and intervention) groups decanted from studies investigating antibiotic (SDD) or non-antibiotic methods of VAP prevention and summarized using random effects meta-analysis of study and group level data. A reference category of groups derived from purely observational studies without any prevention method under study provided a benchmark incidence.

Results

Within SDD RCCTs, the mean bacteremia incidence among concurrent component groups not exposed to PPAP (27 control; 17.1%; 13.1-22.1% and 12 intervention groups; 16.2%; 9.1-27.3%) is double that of the benchmark bacteremia incidence derived from 39 benchmark groups (8.3; 6.8-10.2%) and also 20 control groups from studies of non-antibiotic methods (7.1%; 4.8 – 10.5). There is a selective increase in coagulase negative staphylococci (CNS) but not in Pseudomonas aeruginosa among bacteremia isolates within control groups of SDD-RCCT’s versus benchmark groups with data available.

Conclusions

The topical antibiotic component of SDD presents a major contextual hazard toward bacteremia against which the PPAP component partially mitigates.
Appendix
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Literature
1.
Apostolopoulou E, Bakakos P, Katostaras T, Gregorakos L: Incidence and risk factors for ventilator-associated pneumonia in 4 multidisciplinary intensive care units in Athens, Greece. Respir Care. 2003, 48: 681-688.PubMed
2.
Berg DE, Hershow RC, Ramirez CA, Weinstein RA: Control of nosocomial infections in an intensive care unit in Guatemala City. Clin Infect Dis. 1995, 21: 588-593.PubMed
3.
Bonten MJ, Froon AH, Gaillard CA, Greve JWM, de Leeuw PW, Drent M, Buurman WA: The systemic inflammatory response in the development of ventilator-associated pneumonia. Am J Respir Crit Care Med. 1997, 156: 1105-1113.PubMed
4.
Cade JF, McOwat E, Siganporia R, Keighley C, Presneill J, Sinickas V: Uncertain relevance of gastric colonization in the seriously ill. Intensive Care Med. 1992, 18: 210-7.PubMed
5.
Craven DE, Kunches LM, Lichtenberg DA, Kollisch NR, Barry MA, Heeren TC, McCabe WR: Nosocomial infection and fatality in medical and surgical intensive care unit patients. Arch Intern Med. 1988, 148: 1161-8.PubMed
6.
El-Masri MM, Hammad TA, McLeskey SW, Joshi M, Korniewicz DM: Predictors of nosocomial bloodstream infections among critically ill adult trauma patients. Infect Control Hosp Epidemiol. 2004, 25: 656-663.PubMed
7.
Fagon JY, Chastre J, Domart Y, Trouillet JL, Pierre J, Darne C, Gibert C: Nosocomial pneumonia in patients receiving continuous mechanical ventilation. Prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques. Am Rev Respir Dis. 1989, 139: 877-884.PubMed
8.
Fagon JY, Chastre J, Vuagnat A, Trouillet JL, Novara A, Gibert C: Nosocomial pneumonia and mortality among patients in intensive care units. JAMA. 1996, 275: 866-869.PubMed
9.
Fieselmann JF, Bock MJ, Hendryx MS, Wakefield D, Helms CM, Bentler SE: Mechanical ventilation in rural ICUs. Crit Care. 1999, 3: 23-31.PubMedPubMedCentral
10.
Garrouste-Orgeas M, Chevret S, Mainardi JL, Timsit JF, Misset B, Carlet J: A one-year prospective study of nosocomial bacteraemia in ICU and non-ICU patients and its impact on patient outcome. J Hosp Infect. 2000, 44: 206-213.PubMed
11.
Garrouste-Orgeas M, Timsit JF, Tafflet M, Misset B, Zahar JR, Soufir L, Carlet J: Excess risk of death from intensive care unit—acquired nosocomial bloodstream infections: a reappraisal. Clin Infect Dis. 2006, 42: 1118-1126.PubMed
12.
George DL, Falk PS, Wunderink RG, Leeper KV, Meduri GU, Steere EL, Glen Mayhall C: Epidemiology of ventilator-acquired pneumonia based on protected bronchoscopic sampling. Am J Respir Crit Care Med. 1998, 158: 1839-1847.PubMed
13.
Giard M, Lepape A, Allaouchiche B, Guerin C, Lehot JJ, Robert MO, Vanhems P: Early-and late-onset ventilator-associated pneumonia acquired in the intensive care unit: comparison of risk factors. J Crit Care. 2008, 23: 27-33.PubMed
14.
Girou E, Schortgen F, Delclaux C, Brun-Buisson C, Blot F, Lefort Y, Brochard L: Association of noninvasive ventilation with nosocomial infections and survival in critically ill patients. JAMA. 2000, 284: 2361-2367.PubMed
15.
Guimaraes MM, Rocco JR: Prevalence of ventilator-associated pneumonia in a university hospital and prognosis for the patients affected. J Bras Pneumol. 2006, 32: 339-346.PubMed
16.
Hébert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, Yetisir E: A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. New Engl J Med. 1999, 340: 409-417.PubMed
17.
Hugonnet S, Eggimann P, Borst F, Maricot P, Chevrolet JC, Pittet D: Impact of ventilator-associated pneumonia on resource utilization and patient outcome. Infect Control Hosp Epidemiol. 2004, 25: 1090-6.PubMed
18.
Ibrahim EH, Ward S, Sherman G, Kollef MH: A comparative analysis of patients with early-onset vs late-onset nosocomial pneumonia in the ICU setting. Chest. 2000, 117: 1434-1442.PubMed
19.
Jacobs S, Chang RW, Lee B, Bartlett FW: Continuous enteral feeding: a major cause of pneumonia among ventilated intensive care unit patients. JPEN J Parenter Enteral Nutr. 1990, 14: 353-6.PubMed
20.
Kollef MH, Vlasnik J, Sharpless L, Pasque C, Murphy D, Fraser V: Scheduled change of antibiotic classes A strategy to decrease the incidence of ventilator-associated pneumonia. Am J Respir Crit Care Med. 1997, 156: 1040-1048.PubMed
21.
Kunac A, Sifri ZC, Mohr AM, Horng H, Lavery RF, Livingston DH: Bacteremia and ventilator-associated pneumonia: a marker for contemporaneous extra-pulmonic infection. Surg Infect. 2014, 15: 77-83.
22.
Laupland KB, Zygun DA, Davies HD, Church DL, Louie TJ, Doig CJ: Population-based assessment of intensive care unit-acquired bloodstream infections in adults: incidence, risk factors, and associated mortality rate. Crit Care Med. 2002, 30: 2462-2467.PubMed
23.
Laupland KB, Kirkpatrick AW, Church DL, Ross T, Gregson DB: Intensive-care-unit-acquired bloodstream infections in a regional critically ill population. J Hosp Infect. 2004, 58 (2): 137-145.PubMed
24.
Magnason S, Kristinsson KG, Stefansson T, Erlendsdottir H, Jonsdottir K, Kristjansson M, Gudmundsson S: Risk factors and outcome in ICU‐acquired infections. Acta Anaesthesiol Scand. 2008, 52: 1238-1245.PubMed
25.
Nourdine K, Combes P, Carton MJ, Beuret P, Cannamela A, Ducreux JC: Does noninvasive ventilation reduce the ICU nosocomial infection risk? A prospective clinical survey. Intensive Care Med. 1999, 25: 567-573.PubMed
26.
Osmon S, Warren D, Seiler SM, Shannon W, Fraser VJ, Kollef MH: The influence of infection on hospital mortality for patients requiring >48 h of intensive care. Chest. 2003, 124: 1021-1029.PubMed
27.
Potgieter PD, Linton DM, Oliver S, Forder AA: Nosocomial infections in a respiratory intensive care unit. Crit Care Med. 1987, 15: 495-498.PubMed
28.
Rello J, Ricart M, Mirelis B, Quintana E, Gurgui M, Net A, Prats G: Nosocomial bacteremia in a medical-surgical intensive care unit: epidemiologic characteristics and factors influencing mortality in 111 episodes. Intensive Care Med. 1994, 20: 94-98.PubMed
29.
Reusser P, Zimmerli W, Scheidegger D, Marbet GA, Buser M, Gyr K: Role of gastric colonization in nosocomial infections and endotoxemia: a prospective study in neurosurgical patients on mechanical ventilation. J Infect Dis. 1989, 160: 414-421.PubMed
30.
Salata RA, Lederman MM, Shlaes DM, Jacobs MR, Eckstein E, Tweardy D, Toossi Z, Chmielewski R, Marino J, King CH: Diagnosis of nosocomial pneumonia in intubated, intensive care unit patients. Am Rev Respir Dis. 1987, 135: 426-432.PubMed
31.
Shorr AF, Duh MS, Kelly KM, Kollef MH: Red blood cell transfusion and ventilator-associated pneumonia: a potential link?. Crit Care Med. 2004, 32: 666-674.PubMed
32.
Shorr AF, Jackson WL, Kelly KM, Fu M, Kollef MH: Transfusion practice and blood stream infections in critically ill patients. Chest. 2005, 127: 1722-1728.PubMed
33.
Sofianou DC, Constandinidis TC, Yannacou M, Anastasiou H, Sofianos E: Analysis of risk factors for ventilator-associated pneumonia in a multidisciplinary intensive care unit. Eur J Clin Microbiol Infect Dis. 2000, 19: 460-463.PubMed
34.
Torres A, Aznar R, Gatell JM, Jimenez P, Gonzalez J, Ferrer A, Celis R, Rodriguez-Roisin R: Incidence, risk, and prognosis factors of nosocomial pneumonia in mechanically ventilated patients. Am Rev Respir Dis. 1990, 142: 523-528.PubMed
35.
Urli T, Perone G, Acquarolo A, Zappa S, Antonini B, Ciani A: Surveillance of infections acquired in intensive care: usefulness in clinical practice. J Hosp Infect. 2002, 52: 130-5.PubMed
36.
Violan JS, Sanchez-Ramirez C, Mujica AP, Cendrero JC, Fernandez JA, de Castro FR: Impact of nosocomial pneumonia on the outcome of mechanically-ventilated patients. Crit Care (Lond). 1998, 2: 19-23.
37.
Acosta-Escribano J, Fernández-Vivas M, Carmona TG, Caturla-Such J, Garcia-Martinez M, Menendez-Mainer A, Sanchez-Payá J: Gastric versus transpyloric feeding in severe traumatic brain injury: a prospective, randomized trial. Intensive Care Med. 2010, 36: 1532-1539.PubMed
38.
Barraud D, Blard C, Hein F, Marçon O, Cravoisy A, Nace L, Alla F, Bollaert PE, Gibot S: Probiotics in the critically ill patient: a double blind, randomized, placebo-controlled trial. Intensive Care Med. 2010, 36: 1540-1547.PubMed
39.
Bonten MJ, Gaillard CA, Van der Geest S, Van Tiel FH, Beysens AJ, Smeets HG, Stobberingh EE: The role of intragastric acidity and stress ulcus prophylaxis on colonization and infection in mechanically ventilated ICU patients. A stratified, randomized, double-blind study of sucralfate versus antacids. Am J Respir Crit Care Med. 1995, 152: 1825-1834.PubMed
40.
Doig GS, Simpson F, Sweetman EA, Finfer SR, Cooper DJ, Heighes PT, Peake S: Early parenteral nutrition in critically ill patients with short-term relative contraindications to early enteral nutrition: a randomized controlled trial. JAMA. 2013, 309: 2130-2138.PubMed
41.
Harvey SE, Parrott F, Harrison DA, Bear DE, Segaran E, Beale R, Bellingan G, Leonard R, Mythen MG, Rowan KM: Trial of the route of early nutritional support in critically ill adults. N Engl J Med. 2014, 371: 1673-1684.PubMed
42.
Hsu CW, Sun SF, Lin SL, Kang SP, Chu KA, Lin CH, Huang HH: Duodenal versus gastric feeding in medical intensive care unit patients: a prospective, randomized, clinical study. Crit Care Med. 2009, 37: 1866-1872.PubMed
43.
Ibrahim EH, Mehringer L, Prentice D, Sherman G, Schaiff R, Fraser V, Kollef MH: Early versus late enteral feeding of mechanically ventilated patients: results of a clinical trial. JPEN J Parenter Enteral Nutr. 2002, 26: 174-181.PubMed
44.
Kearns PJ, Chin D, Mueller L, Wallace K, Jensen WA, Kirsch CM: The incidence of ventilator-associated pneumonia and success in nutrient delivery with gastric versus small intestinal feeding: a randomized clinical trial. Crit Care Med. 2000, 28: 1742-1746.PubMed
45.
Laggner AN, Lenz K, Base W, Druml W, Schneeweiss B, Grimm G: Prevention of upper gastrointestinal bleeding in long-term ventilated patients. Sucralfate versus ranitidine. Am J Med. 1989, 86: 81-4.PubMed
46.
Montecalvo MA, Steger KA, Farber HW: Nutritional outcome and pneumonia in critical care patients randomized to gastric versus jejunal tube feedings. The Critical Care Research Team Crit Care Med. 1992, 20: 1377-1387.PubMed
47.
Oudhuis GJ, Bergmans DC, Dormans T, Zwaveling JH, Kessels A, Prins MH, Verbon A: Probiotics versus antibiotic decontamination of the digestive tract: infection and mortality. Intensive Care Med. 2011, 37: 110-117.PubMed
48.
Reignier J, Mercier E, Le Gouge A, Boulain T, Desachy A, Bellec F, Lascarrou JB: Effect of not monitoring residual gastric volume on risk of ventilator-associated pneumonia in adults receiving mechanical ventilation and early enteral feeding. A randomized controlled trial. JAMA. 2013, 309: 249-256.PubMed
49.
Spindler-Vesel A, Bengmark S, Vovk I, Cerovic O, Kompan L: Synbiotics, prebiotics, glutamine, or peptide in early enteral nutrition: a randomized study in trauma patients. J Parenter Enteral Nutr. 2007, 31: 119-126.
50.
Camus C, Bellissant E, Sebille V, Perrotin D, Garo B, Legras A, Renault A, Le Corre P, Donnio PY, Gacouin A: Prevention of acquired infections in intubated patients with the combination of two decontamination regimens. Crit Care Med. 2005, 33: 307-314.PubMed
51.
DeRiso AJ, Ladowski JS, Dillon TA, Justice JW, Peterson AC: Chlorhexidine gluconate 0.12% oral rinse reduces the incidence of total nosocomial respiratory infection and nonprophylactic systemic antibiotic use in patients undergoing heart surgery. Chest. 1996, 109: 1556-1561.PubMed
52.
Fourrier F, Cau-Pottier E, Boutigny H, Roussel-Delvallez M, Jourdain M, Chopin C: Effects of dental plaque antiseptic decontamination on bacterial colonization and nosocomial infections in critically ill patients. Intensive Care Med. 2000, 26: 1239-1247.PubMed
53.
Fourrier F, Dubois D, Pronnier P, Herbecq P, Leroy O, Desmettre T, Roussel-Delvallez M: Effect of gingival and dental plaque antiseptic decontamination on nosocomial infections acquired in the intensive care unit a double-blind placebo-controlled multicenter study. Crit Care Med. 2005, 33: 1728-1735.PubMed
54.
Holzapfel L, Chevret S, Madinier G, Ohen F, Demingeon G, Coupry A, Chaudet M: Influence of long-term oro- or nasotracheal intubation on nosocomial maxillary sinusitis and pneumonia: results of a prospective, randomized, clinical trial. Crit Care Med. 1993, 21: 1132-1138.PubMed
55.
Holzapfel L, Chastang C, Demingeon G, Bohe J, Piralla B, Coupry A: A randomized study assessing the systematic search for maxillary sinusitis in nasotracheally mechanically ventilated patients. Influence of nosocomial maxillary sinusitis on the occurrence of ventilator-associated pneumonia. Am J Respir Crit Care Med. 1999, 159: 695-701.PubMed
56.
Segers P, Speekenbrink RG, Ubbink DT, van Ogtrop ML, Bas A: Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate. JAMA. 2006, 296: 2460-2466.PubMed
57.
Seguin P, Tanguy M, Laviolle B, Tirel O, Malledant Y: Effect of oropharyngeal decontamination by povidone-iodine on ventilator-associated pneumonia in patients with head trauma. Crit Care Med. 2006, 34: 1514-1519.PubMed
58.
Valencia M, Ferrer M, Farre R, Navajas D, Badia JR, Nicolas JM, Torres A: Automatic control of tracheal tube cuff pressure in ventilated patients in semirecumbent position: a randomized trial. Crit Care Med. 2007, 35: 1543-1549.PubMed
59.
Brun-Buisson C, Legrand P, Rauss A, Richard C, Montravers F, Besbes M, Meakins JL, Soussy CJ, Lemaire F: Intestinal decontamination for control of nosocomial multiresistant gram-negative bacilli. Study of an outbreak in an intensive care unit. Ann Intern Med. 1989, 110: 873-881.PubMed
60.
de Smet AMGA, Kluytmans JAJW, Cooper BS, Mascini EM, Benus RFJ, van der Werf TS, van der Hoeven JG, Pickkers P, Bogaers-Hofman D, van der Meer NJ, Bernards AT, Kuijper EJ, Joore JC, Leverstein-van Hall MA, Bindels AJ, Jansz AR, Wesselink RM, de Jongh BM, Dennesen PJ, van Asselt GJ, te Velde LF, Frenay IH, Kaasjager K, Bosch FH, van Iterson M, Thijsen SF, Kluge GH, Pauw W, de Vries JW, Kaan JA, Arends JP, Aarts LP, Sturm PD, Harinck HI, Voss A, Uijtendaal EV, Blok HE, Thieme Groen ES, Pouw ME, Kalkman CJ, Bonten MJ: Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med. 2009, 360: 20-31.PubMed
61.
Godard J, Guillaume C, Reverdy ME, Bachmann P, Bui-Xuan B, Nageotte A, Motin J: Intestinal decontamination in a polyvalent ICU. A double-blind study. Intensive Care Med. 1990, 16: 307-311.PubMed
62.
Nardi G, Di Silvestre A, De Monte A, Massarutti D, Proietti A, Troncon MG, Zussino M: Reduction in gram-positive pneumonia and antibiotic consumption following the use of a SDD protocol including nasal and oral mupirocin. Eur J Emerg Med. 2001, 8: 203-214.PubMed
63.
Oostdijk EA, Kesecioglu J, Schultz MJ, Visser CE, de Jonge E, van Essen EH, Bernards AT, Purmer I, Brimicombe R, Bergmans D, van Tiel F, Bosch FH, Mascini E, van Griethuysen A, Bindels A, Jansz A, van Steveninck FAL, van der Zwet WC, Fijen JW, Thijsen S, de Jong R, Oudbier J, Raben A, van der Vorm E, Koeman M, Rothbarth P, Rijkeboer A, Gruteke P, Hart-Sweet H, Peerbooms P, Winsser LJ, van Elsacker-Niele AMW, Demmendaal K, Brandenburg A, de Smet AMGA, Bonten MJM: Effects of decontamination of the oropharynx and intestinal tract on antibiotic resistance in ICUs: a randomized clinical trial. JAMA. 2014, 312: 1429-1437.PubMed
64.
Cerdá E, Abella A, Miguel A, Lorente JA, García-Hierro P, van Saene HK, Alia A, Aranguren A: Enteral vancomycin controls methicillin-resistant Staphylococcus aureus endemicity in an intensive care burn unit: a 9-year prospective study. Ann Surg. 2007, 245: 397-407.PubMedPubMedCentral
65.
Fox MA, Peterson S, Fabri BM, Van Saene HK, Williets T: Selective decontamination of the digestive tract in cardiac surgical patients. Crit Care Med. 1991, 19: 1486-90.PubMed
66.
Hammond JM, Potgieter PD: Long-term effects of selective decontamination on antimicrobial resistance. Crit Care Med. 1995, 23: 637-45.PubMed
67.
Ledingham I, Eastaway A, Mckay I, Alcock S, Mcdonald J, Ramsay G: Triple regimen of selective decontamination of the digestive tract, systemic cefotaxime, and microbiological surveillance for prevention of acquired infection in intensive care. Lancet. 1988, 1: 785-90.PubMed
68.
McClelland P, Murray AE, Williams PS, van Saene HK, Gilbertson AA, Mostafa SM, Bone JM: Reducing sepsis in severe combined acute renal and respiratory failure by selective decontamination of the digestive tract. Crit Care Med. 1990, 18: 935-9.PubMed
69.
Silvestri L, Bragadin CM, Milanese M, Gregori D, Consales C, Gullo A, van Saene HFK: Are most ICU infections really nosocomial? A prospective observational cohort study in mechanically ventilated patients. J Hosp Infect. 1999, 42: 125-133.PubMed
70.
Silvestri L, Van Saene HKF, Milanese M, Fontana F, Gregori D, Oblach L, Blazic M: Prevention of MRSA pneumonia by oral vancomycin decontamination: a randomised trial. Eur Resp J. 2004, 23: 921-926.
71.
Stoutenbeek CP, van Saene HK, Miranda DR, Zandstra DF, Langrehr D: The effect of oropharyngeal decontamination using topical nonabsorbable antibiotics on the incidence of nosocomial respiratory tract infections in multiple trauma patients. J Trauma. 1987, 27: 357-364.PubMed
72.
Sydow M, Burchardi H, Crozier TA: [The effect of selective decontamination on nosocomial infections, their causative agents and antibiotic resistance in long-term intubated intensive care patients]. Anasth Intensivther Notfall Med. 1990, 25: 416-23.
73.
van Patot HT, Leusink JA, Roodenburg J, De Jongh BM, Lau HS, de Boer S, De Boer A: Selective decontamination of the digestive tract: effect of cessation of routine application at an ICU. Pharm World Sci. 1996, 18: 171-177.
74.
Viviani M, Van Saene HK, Dezzoni R, Silvestri L, Di Lenarda R, Berlot G, Gullo A: 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. 2005, 33: 361-372.PubMed
75.
Barret JP, Jeschke MG, Herndon DN: Selective decontamination of the digestive tract in severely burned pediatric patients. Burns. 2001, 27: 439-445.PubMed
76.
Garbino J, Lew DP, Romand JA, Hugonnet S, Auckenthaler R, Pittet D: Prevention of severe Candida infections in nonneutropenic, high-risk, critically ill patients: a randomized, double-blind, placebo-controlled trial in patients treated by selective digestive decontamination. Intensive Care Med. 2002, 28: 1708-1717.PubMed
77.
Gaussorgues P, Salord M, Sirodot S, Tigaud S, Cagnin S, Gerard M, Robert D: Efficiency of selective decontamination of the digestive tract on the occurrence of nosocomial bacteremia in patients on mechanical ventilation receiving betamimetic therapy. Réan Soins Intens Méd Urg. 1991, 7: 169-174.
78.
Korinek AM, Laisne MJ, Nicolas MH, Raskine L, Deroin V, Sanson-Lepors MJ: Selective decontamination of the digestive tract in neurosurgical intensive care unit patients: a double-blind, randomized, placebo-controlled study. Crit Care Med. 1993, 21: 1466-1473.PubMed
79.
Langlois-Karaga A, Bues-Charbit M, Davignon A, Albanese J, Durbec O, Martin C, Balansard G: Selective digestive decontamination in multiple trauma patients: cost and efficacy. Pharm World Sci. 1995, 17: 12-16.PubMed
80.
Quinio B, Albanese J, Bues-Charbit M, Viviand X, Martin C: Selective decontamination of the digestive tract in multiple trauma patients. A prospective double-blind, randomized, placebo-controlled study. Chest. 1996, 109: 765-772.PubMed
81.
Rodriguez-Roldan JM, Altuna-Cuesta A, Lopez A, Carrillo A, Garcia J, Leon J, Martinez-Pellus AJ: Prevention of nosocomial lung infection in ventilated patients: use of an antimicrobial pharyngeal nonabsorbable paste. Crit Care Med. 1990, 18: 1239-1242.PubMed
82.
Ruza F, Alvarado F, Herruzo R, Delgado MA, Garcia S, Dorao P, Goded F: Prevention of nosocomial infection in a pediatric intensive care unit (PICU) through the use of selective digestive decontamination. Eur J Epidemiol. 1998, 14: 719-27.PubMed
83.
Wiener J, Itokazu G, Nathan C, Kabins SA, Weinstein RA: A randomized, double-blind, placebo-controlled trial of selective digestive decontamination in a medical-surgical intensive care unit. Clin Infect Dis. 1995, 20: 861-867.PubMed
84.
Aerdts SJ, van Dalen R, Clasener HA, Festen J, van Lier HJ, Vollaard EJ: Antibiotic prophylaxis of respiratory tract infection in mechanically ventilated patients. A prospective, blinded, randomized trial of the effect of a novel regimen. Chest. 1991, 100: 783-791.PubMed
85.
Blair P, Rowlands BJ, Lowry K, Webb H, Armstrong P, Smilie J: Selective decontamination of the digestive tract: a stratified, randomized, prospective study in a mixed intensive care unit. Surgery. 1991, 110: 303-309.PubMed
86.
Cerra FB, Maddaus MA, Dunn DL, Wells CL, Konstantinides NN, Lehmann SL, Mann HJ: Selective gut decontamination reduces nosocomial infections and length of stay but not mortality or organ failure in surgical intensive care unit patients. Arch Surg. 1992, 127: 163-167.PubMed
87.
Cockerill FR, Muller SR, Anhalt JP, Marsh HM, Farnell MB, Mucha P, Gillespie DJ, Ilstrup DM, Larson-Keller JJ, Thompson RL: Prevention of infection in critically ill patients by selective decontamination of the digestive tract. Ann Intern Med. 1992, 117: 545-553.PubMed
88.
de La Cal MA, Cerda E, Garcia-Hierro P, Van Saene HK, Gómez-Santos D, Negro E, Lorente JA: Survival benefit in critically ill burned patients receiving selective decontamination of the digestive tract: a randomized, placebo-controlled, double-blind trial. Ann Surg. 2005, 241: 424-430.PubMedPubMedCentral
89.
Finch RG, Tomlinson P, Holliday M, Sole K, Stack C, Rocker G: Selective Decontamination of the Digestive Tract (SDD) in the Prevention of Secondary Sepsis in a Medical/Surgical Intensive Care Unit [Abstract]. 1991, Seventeenth international congress of chemotherapy, Berlin
90.
Flaherty J, Nathan C, Kabins SA, Weinstein RA: Pilot trial of selective decontamination for prevention of bacterial infection in an intensive care unit. J Infect Dis. 1990, 162: 1393-1397.PubMed
91.
Jacobs S, Foweraker JE, Roberts SE: Effectiveness of selective decontamination of the digestive tract (SDD) in an ICU with a policy encouraging a low gastric pH. Clin Intensive Med. 1992, 3: 52-58.
92.
Kerver AJ, Rommes JH, Mevissen-Verhage EA, Hulstaert PF, Vos A, Verhoef J, Wittebol P: Prevention of colonization and infection in critically ill patients: a prospective randomized study. Crit Care Med. 1988, 16: 1087-1093.PubMed
93.
Krueger WA, Lenhart FP, Neeser G, Ruckdeschel G, Schreckhase H, Eissner HJ, Forst H, Eckart J, Peter K, Unertl KE: 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. 2002, 166: 1029-1037.PubMed
94.
Palomar M, Alvarez-Lerma F, Jorda R, Bermejo B, for the Catalan Study Group of Nosocomial Pneumonia Prevention: Prevention of nosocomial infection in mechanically ventilated patients: selective digestive decontamination versus sucralfate. Clin Intensive Care. 1997, 8: 228-235.
95.
Rocha LA, Martin MJ, Pita S, Paz J, Seco C, Margusino L, Villanueva R, Duran MT: Prevention of nosocomial infection in critically ill patients by selective decontamination of the digestive tract. A randomized, double blind, placebo-controlled study. Intensive Care Med. 1992, 18: 398-404.PubMed
96.
Rolando N, Gimson A, Wade J, Philpott‐Howard J, Casewell M, Williams R: Prospective controlled trial of selective parenteral and enteral antimicrobial regimen in fulminant liver failure. Hepatol. 1993, 17: 196-201.
97.
Sanchez Garcia M, Cambronero Galache JA, Lopez Diaz J, Cerda Cerda E, Rubio Blasco J, Gomez Aguinaga MA, Nunez Reiz A, Rogero Marin S, Onoro Canaveral JJ, Sacristan del Castillo JA: Effectiveness and cost of selective decontamination of the digestive tract in critically ill intubated patients. A randomized, double-blind, placebo-controlled, multicenter trial. Am J Respir Crit Care Med. 1998, 158: 908-916.PubMed
98.
Stoutenbeek CP, van Saene HKF, Little RA, Whitehead A: The effect of selective decontamination of the digestive tract on mortality in multiple trauma patients: a multicenter randomized controlled trial. Intensive Care Med. 2007, 33: 261-70.PubMed
99.
Ulrich C, Harinck-de Weerd JE, Bakker NC, Jacz K, Doornbos L, de Ridder VA: Selective decontamination of the digestive tract with norfloxacin in the prevention of ICU-acquired infections: a prospective randomized study. Intensive Care Med. 1989, 15: 424-431.PubMed
100.
Verwaest C, Verhaegen J, Ferdinande P, Schetz M, Van den Berghe G, Verbist L, Lauwers P: Randomized, controlled trial of selective digestive decontamination in 600 mechanically ventilated patients in a multidisciplinary intensive care unit. Crit Care Med. 1997, 25: 63-71.PubMed
101.
Zobel G, Kuttnig M, Grubbauer HM, Semmelrock HJ, Thiel W: Reduction of colonization and infection rate during pediatric intensive care by selective decontamination of the digestive tract. Crit Care Med. 1991, 19: 1242-1246.PubMed
102.
Arnow PM, Carandang GC, Zabner R, Irwin ME: Randomized controlled trial of selective bowel decontamination for prevention of infections following liver transplantation. Clin Infect Dis. 1996, 22: 997-1003.PubMed
103.
Bion JF, Badger I, Crosby HA, Hutchings P, Kong KL, Baker J, Hutton P, McMaster P, Buckels JA, Elliott TSJ: Selective decontamination of the digestive tract reduces gram-negative pulmonary colonization but not systemic endotoxemia in patients undergoing elective liver transplantation. Crit Care Med. 1994, 22: 40-9.PubMed
104.
Ferrer M, Torres A, Gonzalez J, Puig de la Bellacasa J, el-Ebiary M, Roca M, Gatell JM, Rodriguez-Roisin R: Utility of selective digestive decontamination in mechanically ventilated patients. Ann Intern Med. 1994, 120: 389-395.PubMed
105.
Georges B, Mazerolles M, Decun J-F, Rouge P, Pomies S, Cougot P: Décontamination digestive sélective résultats d'une étude chez le polytraumatisé. Réanimation Soins Intensifs Médecin d'Urgence. 1994, 3: 621-627.
106.
Hammond JM, Potgieter PD, Saunders GL, Forder AA: Double-blind study of selective decontamination of the digestive tract in intensive care. Lancet. 1992, 340: 5-9.PubMed
107.
Hartenauer U, Thulig B, Diemer W, Lawin P, Fegeler W, Kehrel R, Ritzerfeld W: Effect of selective flora suppression on colonization, infection, and mortality in critically ill patients: a one-year, prospective consecutive study. Crit Care Med. 1991, 19: 463-73.PubMed
108.
Hellinger WC, Yao JD, Alvarez S, Blair JE, Cawley JJ, Paya CV, O’Brien PC: A randomized, prospective, double-blinded evaluation of selective bowel decontamination in liver transplantation. Transplantation. 2002, 73: 1904-9.PubMed
109.
Laggner AN, Tryba M, Georgopoulos A, Lenz K, Grimm G, Graninger W, Schneeweiss B, Druml W: Oropharyngeal decontamination with gentamicin for long-term ventilated patients on stress ulcer prophylaxis with sucralfate?. Wien Klin Wochenschr. 1994, 106: 15-19.PubMed
110.
Rolando N, Wade JJ, Stangou A, Gimson AE, Wendon J, Philpott‐Howard J, Williams R: Prospective study comparing the efficacy of prophylactic parenteral antimicrobials, with or without enteral decontamination, in patients with acute liver failure. Liver transpl Surg. 1996, 2: 8-13.PubMed
111.
Stoutenbeek CP, van Saene HKF, Zandstra DF: Prevention of multiple organ failure by selective decontamination of the digestive tract in multiple trauma patients. The Immune Consequences of Shock, Trauma and Sepsis. Edited by: Faist E, Baue AE, Schildberg FW. 1996, Pabst Science, Lengerich, 1055-66.
112.
Tetteroo GWM, Castelein A, Tilanus HW, Ince C, Bruining HA, Wagenvoort JHT: Selective decontamination to reduce gram-negative colonisation and infections after oesophageal resection. Lancet. 1990, 335: 704-7.PubMed
113.
Pittet D, Tarara D, Wenzel RP: Nosocomial bloodstream infection in critically ill patients: excess length of stay, extra costs, and attributable mortality. JAMA. 1994, 271: 1598-1601.PubMed
114.
Vallés J, León C, Alvarez-Lerma F: Nosocomial bacteremia in critically ill patients: a multicenter study evaluating epidemiology and prognosis. Spanish collaborative group for infections in intensive care units of Sociedad Espanola de Medicina Intensiva y Unidades Coronarias (SEMIUC). Clin Infect Dis. 1997, 24: 387-395.PubMed
115.
Bonten MJ, Gaillard CA, de Leeuw PW, Stobberingh EE: Role of colonization of the upper intestinal tract in the pathogenesis of ventilator-associated pneumonia. Clin Infect Dis. 1997, 24: 309-319.PubMed
116.
Oostdijk EA, de Smet AMG, Kesecioglu J, Bonten MJ, Dutch SOD-SDD Trialists Group: The role of intestinal colonization with gram-negative bacteria as a source for intensive care unit-acquired bacteremia. Crit Care Med. 2011, 39: 961-966.PubMed
117.
Silvestri L, van Saene HKF, Casarin A, Berlot G, Gullo A: Impact of selective decontamination of the digestive tract on carriage and infection due to Gram-positive and Gram-negative bacteria. A systematic review of randomised controlled trials. Anaesth Intensive Care. 2008, 36: 324-338.PubMed
118.
Silvestri L, Van Saene HKF, Milanese M, Gregori D, Gullo A: Selective decontamination of the digestive tract reduces bacterial bloodstream infection and mortality in critically ill patients. Systematic review of randomized, controlled trials. J Hosp Infect. 2007, 65: 187-203.PubMed
119.
Liberati A, D'Amico R, Pifferi S, Torri V, Brazzi L, Parmelli E: Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database Syst Rev 2004;(1):CD000022.,
120.
Hurley JC: Prophylaxis with enteral antibiotics in ventilated patients: selective decontamination or selective cross-infection?. Antimicrob Agents Chemother. 1995, 39: 941-947.PubMedPubMedCentral
121.
Hurley JC: Profound effect of study design factors on ventilator-associated pneumonia incidence of prevention studies: benchmarking the literature experience. J Antimicrob Chemother. 2008, 61: 1154-1161.PubMed
122.
Hurley JC: Ventilator associated pneumonia prevention methods using topical antibiotics: herd protection or herd peril?. Chest. 2014, 146 (4): 890-898.PubMed
123.
Hurley JC: The perfidious effect of topical placebo: calibration of staphylococcus aureus ventilator-associated pneumonia incidence within selective digestive decontamination studies versus the broader evidence base. Antimicrob Agents Chemother. 2013, 57: 4524-4531.PubMedPubMedCentral
124.
Hurley JC: Lack of impact of selective digestive decontamination on pseudomonas aeruginosa ventilator-associated pneumonia: benchmarking the evidence base. J Antimicrob Chemother. 2011, 66: 1365-1373.PubMed
125.
Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM: CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988, 16: 128-140.PubMed
126.
Greenland S, O’Rourke K: Meta-analysis. Modern Epidemiology. Edited by: Rothman KJ, Greenland S, Lash TL. 2008, Lippincott, Williams and Wilkins, Philadelphia, PA, 652-682. 3
127.
Harris RJ, Bradburn MJ, Deeks JJ, Harbord RM, Altmamn DG, Sterne JAC: Metan: fixed and random effects-meta-analysis. Stata J. 2008, 8: 3-28.
128.
Harbord RM, Higgins JPT: Meta-regression in Stata. Stata J. 2008, 8: 493-519.
129.
Pittet D, Li N, Woolson RF, Wenzel RP: Microbiological factors influencing the outcome of nosocomial bloodstream infections: a 6-year validated, population-based model. Clin Infect Dis. 1997, 24: 1068-1078.PubMed
130.
Agbaht K, Diaz E, Muñoz E, Lisboa T, Gomez F, Depuydt PO, Blot SI, Rello J: Bacteremia in patients with ventilator-associated pneumonia is associated with increased mortality: a study comparing bacteremic vs. nonbacteremic ventilator-associated pneumonia. Crit Care Med. 2007, 35: 2064-2070.PubMed
131.
Klouwenberg PMK, Ong DS, Bos LD, de Beer FM, van Hooijdonk RT, Huson MA, Cremer OL: Interobserver agreement of centers for disease control and prevention criteria for classifying infections in critically ill patients. Crit Care Med. 2013, 41: 2373-2378.
132.
Oostdijk EA, de Smet AM, Blok HE, Thieme Groen ES, van Asselt GJ, Benus RF, Bernards SAT, Bonten MJ: Ecological effects of selective decontamination on resistant gram-negative bacterial colonization. Am J Respir Crit Care Med. 2010, 181: 452-457.PubMed
133.
van der Kooi TI, de Boer AS, Manniën J, Wille JC, Beaumont MT, Mooi BW, van den Hof S: Incidence and risk factors of device-associated infections and associated mortality at the intensive care in the Dutch surveillance system. Intensive Care Med. 2007, 3: 271-278.
134.
Canter RR, Harvey SE, Harrison DA, Campbell MK, Rowan KM, Cuthbertson BH: Observational study of current use of selective decontamination of the digestive tract in UK critical care units. Br J Anaesth. 2014, 113 (4): 610-617.PubMed
135.
Martin MA, Pfaller MA, Wenzel RP: Coagulase-negative staphylococcal bacteremia mortality and hospital stay. Ann Intern Med. 1989, 110: 9-16.PubMed
136.
Digiovine B, Chenoweth C, Watts C, Higgins M: The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J Respir Crit Care Med. 1999, 160: 976-981.PubMed
137.
Kieft H, Hoepelman AI, Zhou W, Rozenberg-Arska M, Struyvenberg A, Verhoef J: The sepsis syndrome in a Dutch university hospital: clinical observations. Arch Int Med. 1993, 153: 2241-2247.
138.
Daxboeck F, Rabitsch W, Blacky A, Stadler M, Kyrle PA, Hirschl AM, Koller W: Influence of selective bowel decontamination on the organisms recovered during bacteremia in neutropenic patients. Infect Control Hosp Epidemiol. 2004, 25: 685-689.PubMed
139.
Stoutenbeek CP, van Saene HK, Miranda DR, Zandstra DF: The effect of selective decontamination of the digestive tract on mortality in multiple trauma patients: a multicenter randomized controlled trial. Intensive Care Med. 2007, 33: 261-270.PubMed
140.
Hurley JC: Inapparent outbreaks of ventilator-associated pneumonia: an ecologic analysis of prevention and cohort studies. Infect Control Hosp Epidemiol. 2005, 26: 374-390.PubMed
141.
Hurley JC: Paradoxical ventilator associated pneumonia incidences among selective digestive decontamination studies versus other studies of mechanically ventilated patients. Benchmarking the evidence base. Crit Care. 2011, 15: R7-PubMedPubMedCentral
Metadata
Title
Topical antibiotics as a major contextual hazard toward bacteremia within selective digestive decontamination studies: a meta-analysis
Author
James C Hurley
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2014
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-014-0714-x

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