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Selective digestive decontamination

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https://www.readbyqxmd.com/read/29723676/towards-optimal-intraoperative-conditions-in-esophageal-surgery-a-review-of-literature-for-the-prevention-of-esophageal-anastomotic-leakage
#1
REVIEW
Boukje Titia Bootsma, Daitlin Esmee Huisman, Victor Dirk Plat, Linda Jeanne Schoonmade, Jurre Stens, Guy Hubens, Donald Leonard van der Peet, Freek Daams
BACKGROUND: Esophageal anastomotic leakage (EAL) is a severe complication following gastric and esophageal surgery for cancer. Several non-modifiable, patient or surgery related risk factors for EAL have been identified, however, the contribution of modifiable intraoperative parameters remains undetermined. This review provides an overview of current literature on potentially modifiable intraoperative risk factors for EAL. MATERIALS AND METHODS: The PubMed, EMBASE and Cochrane databases were searched by two researchers independently...
April 30, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29628347/impact-of-selective-digestive-decontamination-without-systemic-antibiotics-in-a-major-heart-surgery-intensive-care-unit
#2
María Jesús Pérez-Granda, José M Barrio, Javier Hortal, Almudena Burillo, Patricia Muñoz, Emilio Bouza
PURPOSE: The incidence density of ventilator-associated pneumonia (VAP) is higher in patients undergoing major heart surgery than in other populations, despite the introduction of bundles of preventive measures, because many risk factors are not amenable to intervention. Selective digestive decontamination (SDD) has been shown to be efficacious for decreasing the frequency of VAP, although it has not been incorporated into the routine of most intensive care units. The objective of our study was to evaluate the efficacy of SDD without parenteral antibiotics for preventing VAP in a major heart surgery intensive care unit...
March 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29605022/posttransplant-complications-in-adult-recipients-of-intestine-grafts-without-bowel-decontamination
#3
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
BACKGROUND: Selective digestive decontamination is commonly used to decrease lumenal bacterial flora. Preoperative bowel decontamination may be associated with a lower wound infection rate but has not been shown to decrease risk of intra-abdominal abscess or lower leak rate for enteric anastomoses. Alternatively, the decontamination disrupts the normal flora of the gastrointestinal tract and may affect normal physiology, including immunologic function. This study reports complication rates of an intestine transplant program that has never used bowel decontamination...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29552513/state-of-the-art-review-on-the-renal-and-visceral-protection-during-open-thoracoabdominal-aortic-aneurysm-repair
#4
REVIEW
Karl Waked, Marc Schepens
During open thoracoabdominal aortic aneurysm repair (OTAAAR), there is an inevitable organ ischemic period that occurs when the abdominal arteries are being reattached to the aortic graft. Despite various protective techniques, the incidence of renal and visceral complications remains substantial. This state-of-the-art review gives an overview of the current and most evidence-based organ protection methods during OTAAAR, based on the most recent publications and personal experience. An electronic search was performed in four medical databases, using the following MeSH terms: thoracoabdominal aneurysm, TAAAR, visceral protection, renal protection, kidney, perfusion, and intestines...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29492262/vim-positive-pseudomonas-aeruginosa-in-a-large-tertiary-care-hospital-matched-case-control-studies-and-a-network-analysis
#5
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
https://www.readbyqxmd.com/read/29462291/risk-factors-for-recurrent-helicobacter-cinaedi-bacteremia-and-the-efficacy-of-selective-digestive-decontamination-with-kanamycin-to-prevent-recurrence
#6
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
https://www.readbyqxmd.com/read/29421681/synthesis-of-highly-porous-inorganic-adsorbents-derived-from-metal-organic-frameworks-and-their-application-in-efficient-elimination-of-mercury-ii
#7
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...
May 1, 2018: Journal of Colloid and Interface Science
https://www.readbyqxmd.com/read/29373085/spread-of-vancomycin-resistant-enterococcus-faecium-isolates-despite-validated-infection-control-measures-in-an-italian-hospital-antibiotic-resistance-and-genotypic-characterization-of-the-endemic-strain
#8
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
https://www.readbyqxmd.com/read/29300363/unusually-high-incidences-of-staphylococcus-aureus-infection-within-studies-of-ventilator-associated-pneumonia-prevention-using-topical-antibiotics-benchmarking-the-evidence-base
#9
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
https://www.readbyqxmd.com/read/29244080/quantification-of-methadone-and-main-metabolites-in-nails
#10
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...
April 1, 2018: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29186403/associations-between-enteral-colonization-with-gram-negative-bacteria-and-intensive-care-unit-acquired-infections-and-colonization-of-the-respiratory-tract
#11
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
https://www.readbyqxmd.com/read/29119289/local-antibiotic-decontamination-to-prevent-anastomotic-leakage-short-term-outcome-in-rectal-cancer-surgery
#12
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
https://www.readbyqxmd.com/read/29103639/surveillance-guided-selective-digestive-decontamination-of-carbapenem-resistant-enterobacteriaceae-in-the-intensive-care-unit-a-cost-effectiveness-analysis
#13
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...
March 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/28894438/characterization-of-enterococcus-isolates-colonizing-the-intestinal-tract-of-intensive-care-unit-patients-receiving-selective-digestive-decontamination
#14
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
https://www.readbyqxmd.com/read/28870727/selective-digestive-and-oropharyngeal-decontamination-in-medical-and-surgical-icu-patients-individual-patient-data-meta-analysis
#15
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
https://www.readbyqxmd.com/read/28803549/comparative-gut-microbiota-and-resistome-profiling-of-intensive-care-patients-receiving-selective-digestive-tract-decontamination-and-healthy-subjects
#16
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
https://www.readbyqxmd.com/read/28797573/digestive-decontamination-in-burn-patients-a-systematic-review-of-randomized-clinical-trials-and-observational-studies
#17
REVIEW
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)...
February 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28759469/what-is-new-in-the-prevention-of-nosocomial-pneumonia-in-the-icu
#18
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
https://www.readbyqxmd.com/read/28616203/reduced-rate-of-intensive-care-unit-acquired-gram-negative-bacilli-after-removal-of-sinks-and-introduction-of-water-free-patient-care
#19
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
https://www.readbyqxmd.com/read/28607344/surviving-sepsis-campaign-guidelines-2016-omission-of-selective-decontamination-of-the-digestive-tract-deprives-patients-of-a-level-2b-therapy
#20
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
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