Infection Control in Intensive Care Units by Selective Decontamination: The Use of Oral Non-Absorbable and Parenteral Agents

Front Matter....Pages i-xv
Foreword....Pages 1-1
Introduction....Pages 3-4
Front Matter....Pages 5-5
Classification of Microorganisms Based on Intrinsic Pathogenicity....Pages 8-12
Defence Against Colonization and Infection....Pages 13-21
Oropharyngeal/Gastrointestinal Carriage: Role in Endogenous Colonization and Infection....Pages 22-24
Discussion....Pages 25-26
Impaired Colonization Defence of the Oropharynx....Pages 28-33
Impairment of Defence of the Stomach and Intestine against Colonization in the Critically Ill Patient....Pages 34-41
Pathogenesis of Colonization/Infection of Lower Airways (Endogenous vs Exogenous): Conventional Approaches to Infection Control....Pages 42-48
Discussion....Pages 49-50
Front Matter....Pages 51-51
Prospective Study of Colonization, Infection and Mortality Rates during Conventional Therapy: Glasgow Data [1]....Pages 54-55
Infection and Mortality Rates in Critically Ill Patients during Conventional Antibiotic Regimen....Pages 56-56
A Prospective Study of Colonization and Infection in the Neonatal Surgical Unit at Alder Hey Children’s Hospital, Liverpool, UK....Pages 57-57
Surveillance of Nosocomial Infections in a Surgical ICU: A Prospective Study....Pages 58-58
Prospective Study of Colonization, Infection and Mortality Rates during Conventional Therapy....Pages 59-59
Infection Control in the ICU: Pattern of Colonization and Infection in Surgical Intensive Care Patients — a Prospective Study....Pages 60-60
Discussion....Pages 61-64
Where and How Does Antimicrobial Resistance Develop in the Critically Ill? Studies in Neonatal Patients....Pages 66-73
Do Conventional Policies Control Antibiotic-resistant Bacteria?....Pages 74-82
Discussion....Pages 83-84
Front Matter....Pages 85-85
Philosophy of SDD....Pages 87-87
Concept of Selective Decontamination of the Digestive Tract in the Critically Ill....Pages 88-94
Topical Antibiotic Regimen....Pages 95-101
Use of a Short-term Parenteral Antibiotic as a Supplement to SDD....Pages 102-108
Pharmaceutical Technology in Selective Decontamination....Pages 109-112
Discussion....Pages 113-114
Prospective Study of Colonization, Infection and Mortality in ICU Patients Treated with SDD and Systemic Cefotaxime: Glasgow Results....Pages 117-117
Prospective Study of Infection and Mortality Rates in Critically Ill Patients during SDD Regimen....Pages 118-118
Prospective Studies of Colonization, Infection and Mortality Rates: Liverpool Data....Pages 119-119
Infection Control by Selective Flora Suppression in Critically Ill Patients....Pages 120-120
Prospective Study of Colonization, Infection and Mortality Rates in ICU Patients Receiving SDD: Ulm Results....Pages 121-121
Prevention of Colonization and Subsequent Infection in Critically Ill Patients: a Prospective, Randomized Study....Pages 122-122
The Effect of a Novel Regime of Selective Decontamination on the Incidence of Unit-Acquired Lower Respiratory Tract Infection in Mechanically Ventilated Patients....Pages 123-123
Discussion....Pages 124-126
Significant Reduction of Faecal Endotoxin Pool by Oral Polymyxin E and Tobramycin in Human Volunteers....Pages 128-134
Endotoxaemia in Multiple Organ Failure: A Secondary Role for SDD?....Pages 135-142
Discussion....Pages 143-144
Cefotaxime Combined with Selective Decontamination in Long-term Intensive Care Unit Patients: Virtual Absence of Emergence of Resistance....Pages 146-153
Emergence of Resistance during Selective Decontamination: Glasgow Results....Pages 154-154
Changes in Antibiotic Resistance in Tracheal Aspirates Following Selective Decontamination of the Digestive Tract....Pages 155-155
Front Matter....Pages 85-85
The Liverpool Experience, 1987–1988....Pages 156-157
Colonization and Resistance Patterns of Microbial Isolates following SDD in Association with Short-course Cefotaxime....Pages 158-158
Gram-negative Bacillary Resistance in a Surgical Intensive Care Unit: A Four-Year Surveillance....Pages 159-159
Discussion....Pages 160-162
Front Matter....Pages 163-163
Pathogenesis of Stress Ulcer Bleeding in the Critically Ill....Pages 166-172
Gastric Colonization and Nosocomial Pneumonia in the Mechanically Ventilated Patient....Pages 173-183
New Approaches to the Prevention of Infection in Intensive Care Unit Patients....Pages 184-188
Discussion....Pages 189-190
Front Matter....Pages 191-191
A Possible Explanation for the Success of SDD....Pages 193-196
Discussion....Pages 197-197
Impact of Parenteral Cephalosporins on Human Oropharyngeal and Faecal Flora....Pages 198-202
Discussion....Pages 203-204
Development of Antibiotic Resistance during Conventional and SDD....Pages 205-210
The Gut and Sepsis in the Critically Ill....Pages 211-213
Discussion....Pages 214-214
Conclusions....Pages 215-219
Close....Pages 220-222
Back Matter....Pages 223-235