PREVENTION OF NOSOCOMIAL INFECTION IN CRITICALLY ILL PATIENTS BY SELECTIVE DECONTAMINATION OF THE DIGESTIVE-TRACT - A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY
PREVENTION OF NOSOCOMIAL INFECTION IN CRITICALLY ILL PATIENTS BY SELECTIVE DECONTAMINATION OF THE DIGESTIVE-TRACT - A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY
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DOI：
10.1007/bf01694341
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发表时间：
1992-11-01
影响因子：
38.9
通讯作者：
DURAN, MT
中科院分区：
文献类型：
--
作者：
ROCHA, LA;MARTIN, MJ;DURAN, MT
目的：评价选择性消化道去污（SDD）方法对细菌定植、医院感染（NI）、细菌耐药性、死亡率和经济成本的影响。设计：随机、双盲、安慰剂对照研究。环境：三级医院的多价重症监护室（ICU），有27张床位。患者：101例患者，>机械通气3天，>住院5天，研究开始时无感染。治疗组（TG） 47例，安慰剂组（PG） 54例。干预措施：TG在前4天给予头孢噻肟iv （6 g/天），并在整个住院期间在口咽和胃肠道水平联合使用多粘菌素E、妥布霉素和两性霉素B。结果：在TG中，革兰氏阴性菌在口咽、气管和胃肠道水平的定植明显下降。总体、呼吸和尿NI显著下降（26%对63%，p < 0.001； 15%对46%，p < 0.001）
Objective: To evaluate the effect of a method of Selective Decontamination of the Digestive Tract (SDD) on colonization, nosocomial infection (NI), bacterial resistance, mortality and economic costs. Design: Randomized, double blind, placebo controlled study. Setting: Polyvalent intensive care unit (ICU) of a tertiary care hospital with 27 beds. Patients: 101 patients with > 3 days of mechanical ventilation and > 5 days of stay, without infection at the start of the study. 47 belonged to the Treated Group (TG) and 54 to the Placebo Group (PG). Interventions: The TG was given Cefotaxime iv. (6 g/day) for the first four days and an association of Polymyxin E, Tobramycin and Amphothericin B at the oropharyngeal and gastrointestinal level throughout the whole stay. Results: In the TG, colonization by gram-negative agents at oropharyngeal, tracheal and gastrointestinal level fell significantly. There was a significant drop in the overall, respiratory and urinary NI (26% vs 63%, p < 0.001; 15% vs 46%, p