Decline of multidrug-resistant Gram negative infections with the routine use of a multiple decontamination regimen in ICU.

Objectives: We have shown that the routine use of a multiple decontamination regimen with oropharyngeal and digestive polymyxin/tobramycin/amphotericin B plus mupirocin/chlorhexidine in intubated patients reduced all-cause acquired infections (AIs) in the intensive care unit (ICU). We now assessed the long-term impact of this strategy on AIs involving multidrug-resistant aerobic Gram negative bacilli (AGNB) and acquired episodes of extended-spectrum betalactamase (ESBL)-producing Enterobacteriaceae rectal carriage.

Methods: This was an observational single center study of all patients admitted to an ICU over 5 years (study population).

At-risk drinking is independently associated with ICU and one-year mortality in critically ill nontrauma patients*.

Objectives: The impact of at-risk drinking on the outcomes of nontrauma patients is not well characterized. The aim of this study was to determine whether at-risk drinking is independently associated with the survival of nontrauma patients in an ICU and within 1 year following ICU discharge.

Design: Observational cohort study.

Chronic alcohol exposure, infection, extended circulating white blood cells differentiated by flow cytometry and neutrophil CD64 expression: a prospective, descriptive study of critically ill medical patients.

Background: A history of prolonged and excessive consumption of alcohol increases the risk for infections. The goal of this study was to investigate circulating white blood cells (WBC) differentiated by flow cytometry and neutrophil CD64 expression in excessive alcohol drinkers versus abstinent or moderate drinkers, and in those with or without infection, in medical patients admitted to the intensive care unit (ICU).

Methods: All patients admitted between September 2009 and March 2010 with an ICU-stay of 3 days or more were eligible for inclusion.

The sensitivity of neutrophil CD64 expression as a biomarker of bacterial infection is low in critically ill patients.

Purpose: CD64 expression on the surface of neutrophils has recently been proposed as an early marker of bacterial infection. The goal of this study was to determine whether the CD64 index allows differentiation of bacterial sepsis from viral and fungal sepsis and other inflammatory states in a critical-care setting.

Methods: This was an observational prospective study conducted in a medical ICU of a university hospital.