PREVENTION OF COLONIZATION AND INFECTION IN CRITICALLY ILL PATIENTS - A PROSPECTIVE RANDOMIZED STUDY
PREVENTION OF COLONIZATION AND INFECTION IN CRITICALLY ILL PATIENTS - A PROSPECTIVE RANDOMIZED STUDY
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DOI：
10.1097/00003246-198811000-00001
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发表时间：
1988-11-01
影响因子：
8.8
通讯作者：
WITTEBOL, P
中科院分区：
文献类型：
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作者：
KERVER, AJH;ROMMES, JH;WITTEBOL, P
在一项前瞻性随机研究中，96名重症监护患者被随机分为对照组和研究组，以确定预防革兰氏阴性菌定植是否能预防革兰氏阴性菌感染。研究组在静脉注射抗生素的基础上加用口服非吸收抗菌药物(如妥布霉素、两性霉素B和多粘菌素E)。在逗留期间，对照组口咽、呼吸道和消化道中革兰氏阴性菌的定植增加，而研究组并不倾向于定植革兰氏阴性菌。在对照组，诊断出107例医院感染，而在研究组，诊断出42例医院感染。在研究组中，由革兰氏阴性菌引起的医院感染的频率明显较低。在研究组中，获得性感染导致的死亡率明显较低。我们得出结论，医院内革兰氏阴性菌的定植、感染和随后的死亡可以通过局部应用不可吸收的抗生素来预防。
In a prospective randomized study to determine whether prevention of colonization of Gram-negative bacteria results in prevention of Gram-negative bacterial infections, 96 intensive care patients were randomly allocated into a control group and a study group. The study group received oral nonabsorbable antimicrobial agents (ie, tobramycin, amphotericin B, and polymyxin E) in addition to parenteral antibiotics. Colonization with Gram-negative microorganisms in the oropharynx, and respiratory and digestive tracts increased in the control group during their stay, while the study group did not tend to colonize with Gram-negative bacteria. In the control group, 107 nosocomial infections were diagnosed, vs. 42 nosocomial infections in the study group. Nosocomial infections caused by Gram-negative bacteria were significantly less frequent in the study group. Mortality due to an acquired infection was significantly less frequent in the study group. We conclude that colonization, infection, and subsequent mortality by nosocomial Gram-negative bacteria can be prevented by a regime of topically applied nonabsorable antibiotics.