In this study we review the rationale for using selective digestive decontamination (SDD) in critically ill patients, and its effects on clinical outcomes and rates of infection with antimicrobial-resistant microorganisms. SDD consists of the application of nonabsorbable antibiotics to the oropharynx and through a nasogastric or nasoenteral tube, in association with a 4-day course of an intravenous third-generation cephalosporin. The enteral component aims at preventing oral and rectal colonization with potentially pathogenic nosocomial aerobic gram-negative bacilli and yeasts while preserving normal protective anaerobic enteral flora. The short-course systemic component aims at eradicating oral endogenous gram-positive bacteria. SDD decreases the risk of nosocomial infections, and reduces by one-quarter the mortality of patients on mechanical ventilation in settings with low prevalence of antibiotic resistance. Evidence from randomized trials suggests that SDD does not increase rates of antimicrobial-resistant microorganisms, and may reduce resistance rates to some antibiotics. However, several limitations decrease our confidence on these data, particularly for settings with high baseline rates of antimicrobial-resistant microorganisms. Although SDD has a clear potential to improve clinical outcomes of critically patients, its long-term ecologic effects on rates of antimicrobial resistant require appropriate assessment by large multinational cluster randomized trials. Before these results are available, the use of SDD cannot be recommended in most parts of the world, except in settings with very low baseline prevalence of antibiotic resistance.
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http://dx.doi.org/10.1097/SHK.0000000000000711 | DOI Listing |
Clin Microbiol Infect
January 2025
Clinic for Infectious Diseases and Hospital Hygiene, University Hospital Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland. Electronic address:
Background: Healthcare-associated infections (HAIs) remain a significant challenge worldwide, and the use of multimodal strategies is recommended by the World Health Organization (WHO) to enhance infection prevention.
Objectives: To update the systematic review on facility-level infection prevention and control (IPC) interventions on the WHO Core Component of using multimodal strategies.
Methods: Data Sources: Medline (via PubMed), EMBASE, CINAHL, and the Cochrane library.
Microorganisms
January 2025
UK Health Security Agency, London E14 4PU, UK.
Background: Patients in critical care units (CCUs) are at an increased risk of bloodstream infections (BSIs), which can be associated with central vascular catheters (CVCs). This study describes BSIs, CVC-BSIs, organism distribution, percentage of antimicrobial resistant (AMR) organisms, and case fatality rates (CFRs) over the first six years of a voluntary national CCU surveillance programme in England.
Methods: Surveillance data on BSIs, CVCs, and bed-days between 04/2017 and 03/2023 for adult CCUs were linked to mortality and AMR data, and crude rates were calculated.
World J Microbiol Biotechnol
January 2025
Microbiology, Botany Department, Faculty of Agriculture, Tanta University, Tanta City, 31527, Egypt.
Bee venom (BV) represents a promising natural alternative to conventional antibiotics, particularly significant given its broad-spectrum antimicrobial activity and potential to address the growing challenge of antimicrobial resistance. The prevalence of antimicrobial-resistant microorganisms (AMR) is a global burden that affects human health and the economies of different countries. As a result, several scientific communities around the world are searching for safe alternatives to antibiotics.
View Article and Find Full Text PDFMicroorganisms
December 2024
Rede de Química e Tecnologia/Laboratório Associado para a Química Verde (REQUIMTE/LAQV), Rua Dom Manuel II, Apartado 55142, 4051-401 Porto, Portugal.
Antimicrobials, widely used in livestock, have induced the emergence of antimicrobial-resistant bacteria, prompting farmers to explore alternatives like copper. This study aims to determine antimicrobial residues and Cu concentrations in the liver and kidney of piglets and to investigate the correlation between Cu and antimicrobial use and the resistance to Cu and antimicrobials of isolated from piglets' faeces. Antimicrobial residues were quantified by UHPLC-ToF-MS; Cu was quantified using FAAS; microbiological methods were used for isolation, CuSO minimal inhibitory concentration (MIC), and antimicrobial susceptibility; and to detect genes, Real-Time PCR was used.
View Article and Find Full Text PDFMicroorganisms
November 2024
Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Private Bag X20, Hatfield, Pretoria 0028, South Africa.
In the absence of data on the reporting of resistance to antibiotics, we sought to determine which clonal complexes (CCs)/sequence types (STs) circulate in the food chain in Kosovo and to determine their antibiogram profiles to a panel of 18 antibiotics. From a total of 114 isolates, 21 different typical STs were identified by multilocus sequence typing (MLST). Each isolate derived from the food categories was subjected to tests to verify its susceptibility to the selected antibiotics according to the designed Sensititre GPN3F panel.
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