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Selective digestive decontamination

Anne F Voor In 't Holt, Juliëtte A Severin, Margot B H Hagenaars, Inge de Goeij, Diederik Gommers, Margreet C Vos
Background: Emergence of multidrug-resistant Pseudomonas aeruginosa is of global concern. We aimed to identify epidemiological relationships, the most common way of transmission, and risk factors for presence of Verona Integron-encoded Metallo-β-lactamase (VIM)-positive P. aeruginosa (VIM-PA). Methods: We conducted a network analysis and matched case-control studies (1:2:2). Controls were hospital-based and matched with cases for ward, day of admission (control group 1 and 2) and time between admission and the identification of VIM-PA (control group 1)...
2018: Antimicrobial Resistance and Infection Control
Hideki Araoka, Masaru Baba, Chikako Okada, Muneyoshi Kimura, Tomoaki Sato, Yutaka Yatomi, Kyoji Moriya, Akiko Yoneyama
Background: Previous studies suggest that Helicobacter cinaedi can cause recurrent bacteremia. This study aimed to elucidate the risk factors for recurrent H. cinaedi bacteremia and explore the efficacy of selective digestive decontamination (SDD) as a preventive measure. Methods: We retrospectively reviewed the medical records of all patients with H. cinaedi bacteremia between March 2009 and December 2016 at two Japanese hospitals. Results: We identified 168 patients with H...
February 15, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Jie Li, Xuede Li, Ahmed Alsaedi, Tasawar Hayat, Changlun Chen
Innovative solid-phase adsorbent is needed urgently for highly efficient extraction of mercury (Hg(II)) from aqueous solution. Herein, highly porous inorganic materials, including ZrOx, ZrOxyPhos and ZrSulf, were obtained from topotactic transformations of metal-organic frameworks (MOFs) via a facile ligand extraction process, which preserved the original MOF morphology and introduced useful functionalities. ZrOx and ZrOxyPhos exhibited high adsorption efficiency for Hg(II). And ZrSulf showed fastest adsorption kinetics (1...
February 2, 2018: Journal of Colloid and Interface Science
Raffaela Bressan, Anna Knezevich, Jacopo Monticelli, Floriana Campanile, Marina Busetti, Maria Santagati, Lucilla Dolzani, Annalisa Milan, Dafne Bongiorno, Manuela Di Santolo, Enrico A Tonin, Stefania Stefani, Roberto Luzzati, Cristina Lagatolla
An alarming increase of vancomycin-resistant Enterococcus faecium (VREfm) isolates was detected in an Italian referral hospital subjected to policies of infection control validated by the Joint Commission International. Analysis of the population structure of 122 consecutive, nonreplicate VREfm isolates collected over an 18-month period identified a single major clone that spread around the whole hospital, rapidly establishing an endemic state. It belonged to sequence type (ST) 17 and showed a highly multidrug-resistant phenotype, being resistant to all antimicrobial classes for the carriage of several resistance determinants...
January 26, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
James C Hurley
Selective digestive decontamination (SDD, topical antibiotic regimens applied to the respiratory tract) appears effective for preventing ventilator associated pneumonia (VAP) in intensive care unit (ICU) patients. However, potential contextual effects of SDD on Staphylococcus aureus infections in the ICU remain unclear. The S. aureus ventilator associated pneumonia (S. aureus VAP), VAP overall and S. aureus bacteremia incidences within component (control and intervention) groups within 27 SDD studies were benchmarked against 115 observational groups...
January 4, 2018: Microorganisms
Teresa Patrícia Magalhães, Sara Cravo, Diana Dias da Silva, Ricardo Jorge Dinis-Oliveira, Carlos Afonso, Maria de Lourdes Bastos, Helena Carmo
The quantification of drugs of abuse in keratinized matrices is becoming of special relevance for monitoring consumption and for post-mortem investigations. We aimed to implement an analytical method for the simultaneous detection of morphine (MORF), 6-monoacetylmorphine (6-MAM), methadone (MET), 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) and 2-ethyl-5-methyl-3,3-diphenylpyrrolidine (EMDP) in nails. After decontamination, the nail samples (30 mg) were submitted to an alkaline digestion followed by a two-step liquid-liquid and SPE extraction using mixed-mode cation exchange cartridges...
December 13, 2017: Journal of Analytical Toxicology
Jos F Frencken, Bastiaan H J Wittekamp, Nienke L Plantinga, Cristian Spitoni, Kirsten van de Groep, Olaf L Cremer, Marc J M Bonten
Background: Enteral and respiratory tract colonization with gram-negative bacteria may lead to subsequent infections in critically ill patients. We aimed to clarify the interdependence between gut and respiratory tract colonization and their associations with intensive care unit (ICU)-acquired infections in patients receiving selective digestive tract decontamination (SDD). Methods: Colonization status of the rectum and respiratory tract was determined using twice-weekly microbiological surveillance in mechanically ventilated subjects receiving SDD between May 2011 and June 2015 in a tertiary medical-surgical ICU in the Netherlands...
February 1, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Ulrich Wirth, Susanne Rogers, Kristina Haubensak, Stefan Schopf, Thomas von Ahnen, Hans Martin Schardey
PURPOSE: Anastomotic leakage still presents an issue in rectal cancer surgery with rates of about 11%. As bacteria play a critical role, there is the concept of perioperative local decontamination to prevent anastomotic leakage. METHODS: To ascertain the effectiveness of this treatment, we performed a retrospective analysis on 206 rectal resections with primary anastomosis and routine use of a selective decontamination of the digestive tract (SDD) regimen for local decontamination...
January 2018: International Journal of Colorectal Disease
Joyce H S You, Hong-Kiu Li, Margaret Ip
BACKGROUND: Clinical findings have shown effectiveness and safety of selective digestive decontamination (SDD) for eradication of carbapenem-resistant Enterobacteriaceae (CRE) in high-risk carriers. We aimed to evaluate the cost-effectiveness of SDD guided by CRE surveillance in the intensive care unit (ICU). METHODS: Outcomes of surveillance-guided SDD (test-guided SDD) and no screening (control) in the ICU were compared by Markov model simulations. Model outcomes were CRE infection and mortality rates, direct costs, and quality-adjusted life year (QALY) loss...
November 2, 2017: American Journal of Infection Control
Teresita D J Bello Gonzalez, Phu Pham, Janetta Top, Rob J L Willems, Willem van Schaik, Mark W J van Passel, Hauke Smidt
Enterococci have emerged as important opportunistic pathogens in intensive care units (ICUs). In this study, enterococcal population size and Enterococcus isolates colonizing the intestinal tract of ICU patients receiving Selective Digestive Decontamination (SDD) were investigated. All nine patients included in the study showed substantial shifts in the enterococcal 16S rRNA gene copy number in the gut microbiota during the hospitalization period. Furthermore, 41 Enterococcus spp. strains were isolated and characterized from these patients at different time points during and after ICU hospitalization, including E...
2017: Frontiers in Microbiology
N L Plantinga, A M G A de Smet, E A N Oostdijk, E de Jonge, C Camus, W A Krueger, D Bergmans, J B Reitsma, M J M Bonten
OBJECTIVES: Selective digestive decontamination (SDD) and selective oropharyngeal decontamination (SOD) improved intensive care unit (ICU), hospital and 28-day survival in ICUs with low levels of antibiotic resistance. Yet it is unclear whether the effect differs between medical and surgical ICU patients. METHODS: In an individual patient data meta-analysis, we systematically searched PubMed and included all randomized controlled studies published since 2000. We performed a two-stage meta-analysis with separate logistic regression models per study and per outcome (hospital survival and ICU survival) and subsequent pooling of main and interaction effects...
September 1, 2017: Clinical Microbiology and Infection
Elena Buelow, Teresita D J Bello González, Susana Fuentes, Wouter A A de Steenhuijsen Piters, Leo Lahti, Jumamurat R Bayjanov, Eline A M Majoor, Johanna C Braat, Maaike S M van Mourik, Evelien A N Oostdijk, Rob J L Willems, Marc J M Bonten, Mark W J van Passel, Hauke Smidt, Willem van Schaik
BACKGROUND: The gut microbiota is a reservoir of opportunistic pathogens that can cause life-threatening infections in critically ill patients during their stay in an intensive care unit (ICU). To suppress gut colonization with opportunistic pathogens, a prophylactic antibiotic regimen, termed "selective decontamination of the digestive tract" (SDD), is used in some countries where it improves clinical outcome in ICU patients. Yet, the impact of ICU hospitalization and SDD on the gut microbiota remains largely unknown...
August 14, 2017: Microbiome
Mercedes Rubio-Regidor, Ana Martín-Pellicer, Luciano Silvestri, Hendrik K F van Saene, José A Lorente, Miguel A de la Cal
OBJECTIVE: The objective of this systematic review is to assess the effect of selective digestive decontamination (SDD) or non-absorbable enteral antibiotics (EA) on mortality, the incidence of infection and its adverse effects in burn patients. MATERIAL AND METHODS: Systematic review of randomized clinical trials (RCT) or observational studies enrolling burn patients, and comparing SDD or EA prophylaxis with placebo or no treatment. The search includes Pubmed/Medline, EMBASE, WOS, Cochrane Library (1970-2015)...
August 7, 2017: Burns: Journal of the International Society for Burn Injuries
Michael Klompas
PURPOSE OF REVIEW: To summarize and contextualize recent evidence on preventing ventilator-associated pneumonia (VAP). RECENT FINDINGS: Many centers continue to report dramatic decreases in VAP rates after implementing ventilator bundles. Interpreting these reports is complicated, however, by the subjectivity and lack of specificity of VAP definitions. More objective data suggest VAP rates may not have meaningfully changed over the past decade. If so, this compels us to re-examine and revise the prevention bundles we have been using to prevent VAP...
October 2017: Current Opinion in Critical Care
Joost Hopman, Alma Tostmann, Heiman Wertheim, Maria Bos, Eva Kolwijck, Reinier Akkermans, Patrick Sturm, Andreas Voss, Peter Pickkers, Hans Vd Hoeven
BACKGROUND: Sinks in patient rooms are associated with hospital-acquired infections. The aim of this study was to evaluate the effect of removal of sinks from the Intensive Care Unit (ICU) patient rooms and the introduction of 'water-free' patient care on gram-negative bacilli colonization rates. METHODS: We conducted a 2-year pre/post quasi-experimental study that compared monthly gram-negative bacilli colonization rates pre- and post-intervention using segmented regression analysis of interrupted time series data...
2017: Antimicrobial Resistance and Infection Control
Luciano Silvestri, Hendrick K van Saene, Johannes H Rommes, Andy J Petros, Miguel A de la Cal, Julian F Bion
No abstract text is available yet for this article.
June 12, 2017: Minerva Anestesiologica
Yoshihiro Fujiya, Maki Nagamatsu, Junko Tomida, Yoshiaki Kawamura, Kei Yamamoto, Momoko Mawatari, Satoshi Kutsuna, Nozomi Takeshita, Kayoko Hayakawa, Shuzo Kanagawa, Kazuhisa Mezaki, Masao Hashimoto, Satoru Ishii, Norio Ohmagari
INTRODUCTION: Helicobacter fennelliae is an enterohepatic Helicobacter species causing bacteraemia in immunocompromised hosts. Only a few cases of recurrent H. fennelliae bacteraemia have been reported in Japan and there are no guidelines regarding antimicrobial treatment for H. fennelliae infection. CASE PRESENTATION: H. fennelliae bacteraemia was observed in a patient receiving platinum-based chemotherapy for lung cancer. To prevent recurrence, the patient received antibiotic therapy with cefepime, amoxicillin and doxycycline for 6 weeks, which is similar to the therapy for Helicobactercinaedi bacteraemia...
October 2016: JMM Case Reports
Srinivas Murthy, Nazima Pathan, Brian H Cuthbertson
BACKGROUND: Selective digestive decontamination of the digestive tract involves the routine administration of oral, gastric, and intravenous antibiotics to mechanically ventilated children to prevent hospital-acquired infections. It has a strong evidence base in adults, with limited pediatric evidence. Current utilization of this intervention among pediatric physicians in North America is unknown. METHODS: An electronic survey administered to pediatric critical care and pediatric infectious disease providers in Canada...
June 2017: Journal of Critical Care
Johanna M Pieterse, Dinis Dos Reis Miranda, Wim Rietdijk, Jan Bakker
No abstract text is available yet for this article.
November 18, 2016: Minerva Anestesiologica
Lucía López-Rodríguez, Miguel A de la Cal, Paloma García-Hierro, Raquel Herrero, Judith Martins, Hendrick K F van Saene, José A Lorente
OBJECTIVE: To evaluate whether selective decontamination of the digestive tract (SDD) attenuates organ dysfunction in critically ill burn patients. BACKGROUND: The effect of SDD on the development and progression of organ dysfunction, as an important determinant of mortality in burned patients, is still unknown. We asked whether organ dysfunction is mitigated by treatment with SDD. METHODS: Patients with burns >20% of total body surface or suspected inhalation injury from a randomized placebo-controlled trial were analyzed to determine the relationship between treatment received (placebo or SDD) and the severity of organ dysfunction as measured by the area under the curve of the Sequential Organ Failure Assessment (SOFA) score (and its individual components) from day 1 to day 7 of admission...
November 2016: Shock
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