title: Infection surveillance and selective decontamination of the digestive tract (SDD) in critically ill patients--results of a controlled study.
abstract: All ICU patients were continuously monitored for infections according to a standard protocol by the physician in charge and an infection control nurse during the first quarter of five consecutive years (1980-1984). The number of patients surveyed was 1,009. The average age was 45.5 years and the average period of stay about four days. 733 patients (72.6%) were intubated and artificially ventilated for three days. A fatal outcome resulted in 13.2% of all patients, 1,129 nosocomial infections were registered in 331 patients, which means an infection rate of 32.8%. The most frequent nosocomial infections were those of the respiratory tract (24.3%). Wound infections developed in 16.6%. The urinary tract was affected in 8.8%. Nosocomial septicaemias were observed in 8.7%. Catheter-associated infections were found in 6.7% of the patients. A fatal outcome resulted in 26% of the patients with nosocomial infections and in 6.9% of the non-infected patients, respectively. There was no significant reduction in nosocomial infections over the five-year period in our ICU. Therefore, a study was designed to evaluate the concept of selective decontamination of the digestive tract (SDD) in critically ill patients in our two surgical/traumatological ICUs. A prospective, consecutive, placebo-controlled study in two ICUs was carried out during four six-month periods. 200 patients who were intubated for at least three days, required intensive care for a minimum of five days, and belonged to either class III or IV according to the "Therapeutic Intervention Scoring System" were included in the study. They received either placebo or a prophylaxis regimen, consisting of polymyxin E, tobramycin and amphotericin B.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Klinik und Poliklinik für Anästhesiologie und operative Intensiv-medizin, Westfälische Wilhelms-Universität Münster.
authors.forename: U
authors.initials: U
authors.lastname: Hartenauer
authors.forename: B
authors.initials: B
authors.lastname: Thülig
authors.forename: P
authors.initials: P
authors.lastname: Lawin
authors.forename: W
authors.initials: W
authors.lastname: Fegeler
mesh_terms: D000328:Adult; D000368:Aged; D003666:Decontamination; D004064:Digestive System / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D017053:Infection Control; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged