Long-term (6-year) effect of selective digestive decontamination on antimicrobial resistance in intensive care, multiple-trauma patients
Long-term (6-year) effect of selective digestive decontamination on antimicrobial resistance in intensive care, multiple-trauma patients
复制标题
选择性消化道净化对重症监护、多发性创伤患者抗菌药耐药性的长期（6 年）影响
DOI：
10.1097/01.ccm.0000079606.16776.c5
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发表时间：
2003-08-01
影响因子：
8.8
通讯作者：
Martin, C
中科院分区：
文献类型：
--
作者：
Leone, M;Albanese, J;Martin, C
目标。目的探讨选择性消化去污（SDD）是否对接受不可吸收性抗生素和头孢唑林的患者样本中分离的细菌耐药性有负面影响。设计：病例对照研究。大学三级医院重症监护室病人在6年的时间里，360例多发性创伤患者（病例患者）接受SDD与360例未接受SDD的患者（对照组）进行比较。SDD由多粘菌素E、庆大霉素和两性霉素B组成，应用于口腔黏膜，鼻腔和胃内。前3天给予全身头孢唑林（1 g，每天3次）。在预先确定的时间间隔内收集样本，对病例患者和对照组进行耐药性分析。测量和主要结果：SDD用于一小部分入住重症监护病房的患者（6年研究期间5987例患者中有360例）。观察到革兰氏阳性球菌的相对过度生长。表皮葡萄球菌对甲氧西林的耐药性增加(SDD 76%，对照组63%，p
Objective. To determine whether selective digestive decontamination (SDD) had some negative impact on the bacterial resistance observed in strains isolated from samples from patients receiving nonabsorbable antibiotics and cefazolin.Design: Case-control study.Setting., Intensive care unit of a university tertiary-care hospital.Patients. Over a 6-yr period, 360 multiple trauma patients (case patients) submitted to SDD were compared with 360 patients not receiving SDD (controls).Interventions. SDD consisted of polymyxin E, gentamicin, and amphotericin B and was applied on the buccal mucosa and provided in the nares and the stomach. For the first 3 days, systemic cefazolin (1 g three times a day) was provided. Resistance analysis was performed in case patients and controls on samples collected at predetermined intervals.Measurements and Main Results: SDD was used in a small subset of patients admitted to the intensive care unit (360 of 5987 over the 6-yr study period). A relative overgrowth of gram-positive cocci was observed. Methicillin resistance of Staphylococcus epidermidis was increased (SDD 76%, controls 63%, p