Decontamination of the digestive tract and oropharynx: hospital acquired infections after discharge from the intensive care unit.
OBJECTIVE
To determine the incidence rates of hospital acquired infections (HAI) during the first 14 days after ICU discharge after treatment during ICU-stay with Selective Decontamination of the Digestive tract (SDD), Selective Oropharyngeal Decontamination (SOD) or Standard Care (SC).


METHODS
Prospective observational study.


METHODS
ICUs in two tertiary care hospitals.


METHODS
Patients discharged from the ICU to the ward.


METHODS
None.


RESULTS
Post-ICU incidences of HAI per 1,000 days at risk were 11.2, 12.9 and 8.3 for patients that had received SDD (n = 296), SOD (n = 286) or SC (n = 289) respectively in ICU, yielding relative risks, as compared to SC, of 1.49 (CI(95) 0.9-2.47) for SOD and 1.44 (CI(95) 0.87-2.39) for SDD. Incidences of surgical site infections (per 100 surgical procedures) were 4 after SC and 11.8 and 8 after SOD and SDD (p = 0.04). Among patients that succumbed in the hospital after ICU-stay (n = 58) eight (14%) had developed HAI after ICU discharge; 3 of 21 after SDD, 3 of 15 after SOD and 2 of 22 after SC.


CONCLUSIONS
Incidences of HAI in general wards tended to be higher in patients that had received either SDD or SOD during ICU-stay, but it seems unlikely that these infections have an effect on hospital mortality rates.
de Smet
Anne Marie G A
AM
Division of Perioperative and Emergency Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. a.desmet@umcutrecht.nl
Hopmans
Titia E M
TE
Minderhoud
Albertus L C
AL
Blok
Hetty E M
HE
Gossink-Franssen
Annelies
A
Bernards
Alexandra T
AT
Bonten
Marc J M
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology*; D003666:Decontamination; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009960:Oropharynx / Q000382:microbiology*; D010351:Patient Discharge; D011446:Prospective Studies; D055815:Young Adult