Infection Control in Intensive Care Units by Selective Decontamination

1. Front Matter

   Pages i-xv

   PDF

2. Foreword

   1. Foreword

      • I. McA. Ledingham

      Pages 1-1

3. Introduction

   1. Introduction

      • H. K. F. van Saene

      Pages 3-4

4. Pathogenesis

   1. Front Matter

      Pages 5-5

      PDF

   2. Host Microorganism Relationship in Healthy People

      1. Classification of Microorganisms Based on Intrinsic Pathogenicity

         • J. A. Washington

         Pages 8-12

      2. Defence Against Colonization and Infection

         • C. A. Hart

         Pages 13-21

      3. Oropharyngeal/Gastrointestinal Carriage: Role in Endogenous Colonization and Infection

         • W. G. Johanson

         Pages 22-24

      4. Discussion

         • Hendrik K. F. van Saene, C. P. Stoutenbeek, Peter Lawin, I. McA. Ledingham

         Pages 25-26

   3. Host Microorganism Relationship in the Critically Ill

      1. Impaired Colonization Defence of the Oropharynx

         • W. G. Johanson

         Pages 28-33

      2. Impairment of Defence of the Stomach and Intestine against Colonization in the Critically Ill Patient

         • L. D. Hudson

         Pages 34-41

      3. Pathogenesis of Colonization/Infection of Lower Airways (Endogenous <i>vs</i> Exogenous): Conventional Approaches to Infection Control

         • M. S. Niederman

         Pages 42-48

      4. Discussion

         • Hendrik K. F. van Saene, C. P. Stoutenbeek, Peter Lawin, I. McA. Ledingham

         Pages 49-50

5. The Conventional Approach to Infection Control

   1. Front Matter

      Pages 51-51

      PDF

   2. Clinical Studies

      1. Prospective Study of Colonization, Infection and Mortality Rates during Conventional Therapy: Glasgow Data [1]

         • G. Ramsay

         Pages 54-55

      2. Infection and Mortality Rates in Critically Ill Patients during Conventional Antibiotic Regimen

         • M. Sydow, H. Burchardi, T. A. Crozier, R. Rüchel, C. Busse, W. Seyde

         Pages 56-56

      3. A Prospective Study of Colonization and Infection in the Neonatal Surgical Unit at Alder Hey Children’s Hospital, Liverpool, UK

         • J. Walker

         Pages 57-57

      4. Surveillance of Nosocomial Infections in a Surgical ICU: A Prospective Study

         • U. Hartenauer

         Pages 58-58

      5. Prospective Study of Colonization, Infection and Mortality Rates during Conventional Therapy

         • H. Wiedeck

         Pages 59-59

      6. Infection Control in the ICU: Pattern of Colonization and Infection in Surgical Intensive Care Patients — a Prospective Study

         • A. J. H. Kerver, J. H. Rommes, E. A. E. Verhage

         Pages 60-60

      7. Discussion

         • Hendrik K. F. van Saene, C. P. Stoutenbeek, Peter Lawin, I. McA. Ledingham

         Pages 61-64

Selective decontamination is a technique which combines short-term and long-term antimicrobials to prevent or treat the acquisition and subsequent carriage of microorganisms causing late colonization and infections. The antimicrobials are selective in that they leave the indigenous, mostly anaerobic flora more or less intact, whilst the effective decontamination provides a genuine breakthrough in the endogenous route of pathogenesis. The improvements in decontamination techniques presented here offer significant reduction in infection related morbidity and mortality among trauma patients.

• Sepsis
• Trauma
• care
• infection
• intensive care
• intensive care unit
• mortality
• multiple organ failure
• prevention

• Medical Microbiology, Royal, Liverpool Hospital, Liverpool, UK

  Hendrik K. F. Saene

• Intensieve Zorgen, Onze Lieve Vrouw Gasthuis, Amsterdam, The Netherlands

  C. P. Stoutenbeek

• Klinik für Anästhesiologie und operative Intensivmedizin, Westfälischen Wilhelms-Universität, Münster, Germany

  Peter Lawin

• The Faculty of Medicine, Health Sciences University, Al Ain, United Arab Emirates

  I. McA. Ledingham

Policies and ethics