Selective decontamination of the digestive tract: the mechanism of action is control of gut overgrowth

Silvestri, Luciano; de la Cal, Miguel A.; van Saene, Hendrick K. F.

doi:10.1007/s00134-012-2690-1

Cited by 111Nosocomial Infections in ICUSepsis Diagnosis and TreatmentClinical Nutrition and Gastroenterology

Selective decontamination of the digestive tract: the mechanism of action is control of gut overgrowth

Silvestri, Luciano, de la Cal, Miguel A., van Saene, Hendrick K. F.·2012·Intensive Care Medicine

DOI 10.1007/s00134-012-2690-1

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Abstract

Purpose Gut overgrowth is the pathophysiological event in the critically ill requiring intensive care. In relation to the risk of developing a clinically important outcome, gut overgrowth is defined as ≥10(5) potential pathogens including 'abnormal' aerobic Gram-negative bacilli (AGNB), 'normal' bacteria and yeasts, per mL of digestive tract secretion. Surveillance samples of throat and gut are the only samples to detect overgrowth. Gut overgrowth is the crucial event which precedes both primary and secondary endogenous infection, and a risk factor for the development of de novo resistance. Selective decontamination of the digestive tract (SDD) is an antimicrobial prophylaxis designed to control overgrowth.Methods There have been 65 randomised controlled trials of SDD in 15,000 patients over 25 years and 11 meta-analyses, which are reviewed.Results and conclusions These trials demonstrate that the full SDD regimen using parenteral and enteral antimicrobials reduces lower airway infection by 72 %, blood stream infection by 37 %, and mortality by 29 %. Resistance is also controlled. Parenteral cefotaxime which reaches high salivary and biliary concentrations eradicates overgrowth of 'normal' bacteria such as Staphylococcus aureus in the throat. Enteral polyenes control 'normal' Candida species. Enteral polymyxin and tobramycin, eradicate, or prevent gut overgrowth of 'abnormal' AGNB. Enteral vancomycin controls overgrowth of 'abnormal' methicillin-resistant S. aureus. SDD controls overgrowth by achieving high antimicrobial concentrations effective against 'normal' and 'abnormal' potential pathogens rather than by selectivity.

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Patients who receive selective decontamination of the digestive tract are less likely to develop multiorgan failure or die than patients who do not.
“patients who receive SDD are less likely to develop multiorgan failure91 or die96 than patients who do not”
From The microbiome and critical illness (2016) · cites this paper as [96]
Since the first randomised controlled trial in 1987, selective decontamination of the digestive tract has been tested in more than 65 randomised controlled trials studying more than 15000 patients.
“Since the first (which was also the first positive) randomised controlled trial in 1987,95 SDD has been tested in more than 65 randomised controlled trials studying more than 15000 patients.”
From The microbiome and critical illness (2016) · cites this paper as [96]
Selective decontamination of the digestive tract is the most thoroughly studied intervention in critical care research and has unambiguous benefits in the prevention of infections, multiorgan failure, and death.
“SDD is the most thoroughly studied intervention in critical care research, and has unambiguous benefits in the prevention of infections, multiorgan failure, and death.”
From The microbiome and critical illness (2016) · cites this paper as [96]

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Prospective study comparing the efficacy of prophylactic parenteral antimicrobials, with or without enteral decontamination, in patients with acute liver failure
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All great truths are iconoclastic: selective decontamination of the digestive tract moves from heresy to level 1 truth
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Impact of Selective Decontamination of the Digestive Tract on Carriage and Infection Due to Gram-Negative and Gram-Positive Bacteria: A Systematic Review of Randomised Controlled Trials
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Are most ICU infections really nosocomial? A prospective observational cohort study in mechanically ventilated patients
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SELECTIVE DECONTAMINATION IN PEDIATRIC LIVER TRANSPLANTS
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Impact of selective decontamination of the digestive tract on multiple organ dysfunction syndrome: systematic review of randomized controlled trials
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Prospective endoscopic study of stress erosions and ulcers in critically ill neurosurgical patients
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Staphylococcus aureus Nasal Colonization in Patients with Cirrhosis: Prospective Assessment of Association with Infection
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Antibiotic restriction does not alter endemic colonization with resistant Gram-negative rods in a pediatric intensive care unit
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Survival benefit of the full selective digestive decontamination regimen
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Self-citation
The Polymyxins
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No effect of preoperative selective gut decontamination on endotoxemia and cytokine activation during cardiopulmonary bypass: A randomized, placebo-controlled study
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Probiotics versus antibiotic decontamination of the digestive tract: infection and mortality
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Selective decontamination of subglottic area in mechanically ventilated patients with multiple trauma
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Endogenous endotoxemia of intestinal origin during cardiopulmonary bypass — role of type of flow and protective effect of selective digestive decontamination
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Evidence for Biliary Excretion of Vancomycin into Stool during Intravenous Therapy: Potential Implications for Rectal Colonization with Vancomycin-Resistant Enterococci
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Prevention of nosocomial infection in a pediatric intensive care unit (PICU) through the use of selective digestive decontamination
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Secondary carriage with multi-resistant Acinetobacter baumannii and Klebsiella pneumoniae in an adult ICU population: relationship with nosocomial infections and mortality
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Randomized clinical trial of perioperative selective decontamination of the digestive tract versus placebo in elective gastrointestinal surgery
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Long-term use of selective decontamination of the digestive tract does not increase antibiotic resistance: a 5-year prospective cohort study
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Prevention of pneumonia in an intensive care unit
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Reduction of colonization and infection rate during pediatric intensive care by selective decontamination of the digestive tract
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Effects of Carbapenem Exposure on the Risk for Digestive Tract Carriage of Intensive Care Unit-Endemic Carbapenem-Resistant Pseudomonas aeruginosa Strains in Critically Ill Patients
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Topical Antibiotics on Tracheostoma Prevents Exogenous Colonization and Infection of Lower Airways in Children
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Oropharyngeal decontamination with gentamicin for long-term ventilated patients on stress ulcer prophylaxis with sucralfate?
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Surveillance Cultures
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Prevention of nosocomial infection in mechanically ventilated patients: selective digestive decontamination versus sucralfate
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A prospective study of septicaemia on a paediatric oncology unit: A three-year experience at The Royal Liverpool Children’s Hospital, Alder Hey, UK
Paulus, S. C., van Saene, H. K. F., Hemsworth, S., Hughes, J., Ng, A. Y. L., & Pizer, B. L. (2005) · European Journal of Cancer · doi:10.1016/j.ejca.2005.04.037 · Cited by 43 · see citing works
Microbial Gut Overgrowth Guarantees Increased Spontaneous Mutation Leading to Polyclonality and Antibiotic Resistance in the Critically Ill
van Saene, H., Taylor, N. F., Damjanovic, V., & Sarginson, R. E. (2008) · Current Drug Targets · doi:10.2174/138945008784221189 · Cited by 43 · see citing works
Efficacy of enteral decontamination in the prevention of anastomotic dehiscence and pulmonary infection in esophagogastric surgery
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Influence of Prophylactic Probiotics and Selective Decontamination on Bacterial Translocation in Patients Undergoing Pancreatic Surgery
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Randomized clinical trial of perioperative selective decontamination of the digestive tract versus placebo in elective gastrointestinal surgery
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Levels of Cefotaxime in Body Fluids and Tissues: A Review
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Biliary Concentrations of Fluconazole in a Patient with Candidat Cholecystitis: Case Report
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Concentrations of amphotericin B in faeces and blood of healthy volunteers after the oral administration of various doses
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Reduction of the intestinal endotoxin pool by three different SDD regimens in human volunteers
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Selective decontamination of the digestive tract does not increase resistance in critically ill patients: Evidence from randomized controlled trials
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Self-citation
Gastric Flora in Chronically Mechanically Ventilated Patients: Relationship to Upper and Lower Airway Colonization
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Low dose oral tobramycin treatment for selective decontamination of the digestive tract: a study in human volunteers
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Concentrations of nystatin in faeces after oral administration of various doses of nystatin
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Welkommen to Our World: Emergence of Antibiotic Resistance with Selective Decontamination of the Digestive Tract
Wunderink, R. G. (2010) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200912-1821ed · Cited by 31 · see citing works
Effect of selective decontamination on antibiotic resistance
Vincent, J., & Jacobs, F. (2011) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(11)70067-6 · Cited by 28 · see citing works
Selective Decontamination of the Digestive Tract Contributes to the Control of Disseminated Intravascular Coagulation in Severe Liver Impairment
van Saene, H. K. F., Stoutenbeek, C. P., Faber‐Nijholt, R., & Saene, J. J. M. V. (1992) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/00005176-199205000-00011 · Cited by 28 · see citing works
Differing Pathways of Lower Airway Colonization and Infection According to Mode of Ventilation (Endotracheal vs Tracheotomy)
Morar, P., Singh, V., Makura, Z. G. G., Jones, A. S., Baines, P. B., Selby, A., Sarginson, R. E., Hughes, J., & van Saene, R. (2002) · Archives of Otolaryngology - Head and Neck Surgery · doi:10.1001/archotol.128.9.1061 · Cited by 27 · see citing works
Effect of Amoxycillin on Colonisation Resistance in Human Volunteers
SAENE, H. K. F. V., Stoutenbeek, C. P., Geitz, J. N., Saene, J. J. M. V., & Hart, C. A. (1988) · Microbial Ecology in Health and Disease · doi:10.3402/mehd.v1i3.7412 · Cited by 27 · see citing works
Is Selective Digestive Decontamination Useful in Controlling Aerobic Gram-Negative Bacilli Producing Extended Spectrum Beta-Lactamases?
Abecasis, F., Sarginson, R. E., Kerr, S. J., Taylor, N., & SAENE, H. K. F. V. (2011) · Microbial Drug Resistance · doi:10.1089/mdr.2010.0060 · Cited by 26 · see citing works
Décontamination Digestive Sélective Résultats D'une Étude Chez Le Polytraumatisé
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The Role of Admission Surveillance Cultures in Patients Requiring Prolonged Mechanical Ventilation in the Intensive Care Unit
Viviani, M., van Saene, H. K. F., Pisa, F. E., Lucangelo, U., Silvestri, L., Momesso, E., & Berlot, G. (2010) · Anaesthesia and Intensive Care · doi:10.1177/0310057x1003800215 · Cited by 26 · see citing works
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TREATMENT OF SALMONELLA CARRIERS WITH COLISTIN SULFATE
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Enterobacteriaceae suppression by three different oral doses of polymyxin E in human volunteers
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The effect of amphotericin B on the fungal flora in feces
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SDD, SOD, or oropharyngeal chlorhexidine to prevent pneumonia and to reduce mortality in ventilated patients: which manoeuvre is evidence-based?
Silvestri, L., van Saene, H. K. F., Zandstra, D. F., Viviani, M., & Gregori, D. (2010) · Intensive Care Medicine · doi:10.1007/s00134-010-1809-5 · Cited by 18 · see citing works
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Is There a Role for Selective Decontamination of the Digestive Tract in Primarily Infected Patients in the ICU?
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Protected Environment — Prophylactic Antibiotic Programmes; Microbiological Studies
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Selective Digestive Tract Decontamination: A Tough Pill to Swallow
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Selective Decontamination of the Digestive Tract in Burn Patients: An Evidence-Based Maneuver That Reduces Mortality
Silvestri, L., de la Cal, M. A., Taylor, N., van Saene, H. K. F., & Parodi, P. C. (2010) · Journal of Burn Care & Research · doi:10.1097/bcr.0b013e3181d1b61f · Cited by 13 · see citing works
Self-citation
Reducing susceptibility to bacteremia after experimental burn injury: a role for selective decontamination of the digestive tract
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Descontaminación digestiva selectiva
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Selective digestive decontamination reduces ventilator-associated tracheobronchitis
Silvestri, L., Milanese, M., Taylor, N., Piacente, N., Zandstra, D. F., & van Saene, H. K. F. (2010) · Respiratory Medicine · doi:10.1016/j.rmed.2010.05.023 · Cited by 9 · see citing works
Self-citation
Selective digestive decontamination. Why are intensivists more "resistant" than microorganisms?
Silvestri, L., Petros, A., Cal, M. A. D. L., & Visintin, S. (2011) · PubMed · Cited by 9 · see citing works
Self-citation
Gut overgrowth harms the critically ill
Petros, A., Taylor, N., van Saene, H. K., & Silvestri, L. (2011) · Intensive Care Medicine · doi:10.1007/s00134-011-2287-0 · Cited by 8 · see citing works
Self-citation
Selective digestive decontamination and antibiotic resistance
Bion, J., Taylor, N. F., Petros, A., Silvestri, L., & van Saene, H. (2012) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(11)70276-6 · Cited by 6 · see citing works
Self-citation
Selective Decontamination of the Digestive Tract (SDD). Twenty-five Years of European Experience
Silvestri, L., de la Cal, M. A., & SAENE, H. K. F. V. (2009) · Springer eBooks · doi:10.1007/978-88-470-1436-7_23 · Cited by 6 · see citing works
Self-citation
Combinations of antimicrobial agents. I. The in vitro sensitivity of 100 strains of Pseudomonas aeruginosa to polymyxin B, colistin, carbenicillin, gentamicin and doxycycline and to various combinations of these antibiotics.
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Effects of preoperatively selected gut decontamination on cardiopulmonary bypass-induced endotoxemia.
Jiang, Y., Xiao, Y., & Wang, X. (2007) · PubMed · Cited by 5 · see citing works
Worlds Apart: Proof that SDD Works
Wunderink, R. G. (2010) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.182.12.1564a · Cited by 4 · see citing works
Prevention of Pneumonia in an Intensive Care Unit
Stoutenbeek, H. P. (1990) · Critical Care Medicine · doi:10.1097/00003246-199010000-00038 · Cited by 4 · see citing works
[Excretion of beta-lactam antibiotics in human parotid saliva].
Maier, H., Zerfowski, M., & Schlegel, P. (1991) · PubMed · Cited by 4 · see citing works
Treatment of sepsis
van Saene, H. K., Silvestri, L., Taylor, N., Petros, A., & Bion, J. (2012) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(12)70230-x · Cited by 4 · see citing works
Self-citation
Worlds Apart: Proof that SDD Works
Petros, A., Taylor, N., Damjanovic, V., van Saene, H. K., Abecasis, F., Silvestri, L., & de la Cal, M. A. (2010) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.182.12.1564 · Cited by 4 · see citing works
Self-citation
Selective Digestive Decontamination can be an Infection-Prevention Regimen for the Intoxicated Patients
Yılmazlar, A., Özyurt, G., Kahveci, F., & Göral, G. (2008) · Journal of Pharmacology and Toxicology · doi:10.3923/jpt.2009.36.40 · Cited by 3 · see citing works
Selective digestive decontamination reduces bacteremia following eradication of gut overgrowth
Silvestri, L., Petros, A., Zandstra, D. F., Taylor, N., & van Saene, H. K. (2011) · Critical Care Medicine · doi:10.1097/ccm.0b013e31822d21b8 · Cited by 2 · see citing works
Self-citation
Selective Decontamination of the Digestive Tract May Reinforce the Efficacy of Corticosteroids
Silvestri, L., Rommes, J. H., Petros, A., Taylor, N., & van Saene, H. K. F. (2012) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.185.3.344 · Cited by 2 · see citing works
Self-citation
Selective decontamination and ecology
van Saene, H. K. F., Taylor, N., Silvestri, L., de la Cal, M. A., Petros, A., & Zandstra, D. F. (2012) · Anaerobe · doi:10.1016/j.anaerobe.2012.02.001 · Cited by 1 · see citing works
Self-citation
Gravity may be the law, but it does not impact critical illness related carriage in overgrowth.
Silvestri, L., Zandstra, D. F., Petros, A., Taylor, N., & Hk, V. S. (2012) · PubMed · Cited by 1 · see citing works
Self-citation

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Enrichment of the lung microbiome with gut bacteria in sepsis and the acute respiratory distress syndrome
Dickson, R. P., Singer, B. H., Newstead, M. W., Falkowski, N. R., Erb-Downward, J. R., Standiford, T. J., & Huffnagle, G. B. (2016) · Nature Microbiology · doi:10.1038/nmicrobiol.2016.113 · Cited by 724 · see citing works
The microbiome and critical illness
Dickson, R. P. (2016) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(15)00427-0 · Cited by 460 · see citing works
The Gut as the Motor of Multiple Organ Dysfunction in Critical Illness
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How should we respond to the emergence of plasmid-mediated colistin resistance in humans and animals?
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Randomized clinical trial of selective decontamination of the digestive tract in elective colorectal cancer surgery (SELECT trial)
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Bacterial Dissemination to the Brain in Sepsis
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Altered gut microbiota in the early stage of acute pancreatitis were related to the occurrence of acute respiratory distress syndrome
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The Lung Microbiome and ARDS. It Is Time to Broaden the Model
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Concurrent interspecies and clonal dissemination of OXA-48 carbapenemase
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State-of the-art review on the renal and visceral protection during open thoracoabdominal aortic aneurysm repair
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Microbiota dynamics in a randomized trial of gut decontamination during allogeneic hematopoietic cell transplantation
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An integrative understanding of the large metabolic shifts induced by antibiotics in critical illness
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Trends in ICU mortality and underlying risk over three decades among mechanically ventilated patients. A group level analysis of cohorts from infection prevention studies
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Structural equation modeling the “control of gut overgrowth” in the prevention of ICU-acquired Gram-negative infection
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Impact of Oral Chlorhexidine on Bloodstream Infection in Critically Ill Patients: Systematic Review and Meta-Analysis of Randomized Controlled Trials
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Enterococci, Clostridium difficile and ESBL-producing bacteria: epidemiology, clinical impact and prevention in ICU patients
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Selective digestive decontamination, a seemingly effective regimen with individual benefit or a flawed concept with population harm?
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Nutrition and the gut microbiome during critical illness: A new insight of nutritional therapy
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Is intra-abdominal hypertension a missing factor that drives multiple organ dysfunction syndrome?
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Do we have the guts to go? The abdominal compartment, intra-abdominal hypertension, the human microbiome and exploration class space missions
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Establishing the safety of selective digestive decontamination within the ICU population: a bridge too far?
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The Surviving Sepsis Campaign: Basic/Translational Science Research Priorities*
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Lung and gut microbiota profiling in intensive care unit patients: a prospective pilot study
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Selective Decontamination of the Digestive Tract in Gastrointestinal Surgery: Useful in Infection Prevention? A Systematic Review
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Rethinking antimicrobial stewardship paradigms in the context of the gut microbiome
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Efficacy of preventive interventions against ventilator-associated pneumonia in critically ill patients: an umbrella review of meta-analyses
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Year in review in Intensive Care Medicine 2012. II: Pneumonia and infection, sepsis, coagulation, hemodynamics, cardiovascular and microcirculation, critical care organization, imaging, ethics and legal issues
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Candida and the Gram-positive trio: testing the vibe in the ICU patient microbiome using structural equation modelling of literature derived data
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Structural equation modelling the impact of antimicrobials on the human microbiome. Colonization resistance versus colonization susceptibility as case studies
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Length of intensive care unit stay and the apparent efficacy of antimicrobial-based versus non-antimicrobial-based ventilator pneumonia prevention interventions within the Cochrane review database
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The surviving sepsis campaign: basic/translational science research priorities
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Candida–Acinetobacter–Pseudomonas Interaction Modelled within 286 ICU Infection Prevention Studies
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Anti-infectious decontamination strategies in Dutch intensive care units: A survey study on contemporary practice and heterogeneity
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Estimating the herd effects of anti-microbial-based decontamination (ABD) interventions on intensive care unit (ICU) acquired bloodstream infections: a deductive meta-analysis
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Selective decontamination of the digestive tract: concept and application
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Indirect (herd) effects of topical antibiotic prophylaxis and oral care versus non-antimicrobial methods increase mortality among ICU patients: realigning Cochrane review data to emulate a three-tier cluster randomised trial
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Management of Intra-abdominal Infections due to Carbapenemase-Producing Organisms
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Selective Decontamination of the Digestive Tract in Adult Mechanically Ventilated Patients — An Updated Systematic Review with Bayesian Meta-Analysis
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Candida perforation of the intestine in an HIV-exposed but uninfected infant
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Comprehensive preoperative regime of selective gut decontamination in combination with probiotics, and smectite for reducing endotoxemia and cytokine activation during cardiopulmonary bypass
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Estimating the herd effects of antimicrobial prevention interventions on ventilator-associated pneumonia within ICU populations: a cluster randomized trial emulation using data from Cochrane reviews
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Efficacy and safety of selective decontamination of the digestive tract (SDD) to prevent recurrent hepatic cyst infections in polycystic liver disease: a retrospective case series
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Is Selective Digestive Decontamination Useful for Critically Ill Patients?
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Selective Intestinal Decontamination as a Method for Preventing Infectious Complications (Review)
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A mini-review of the relationship between intestinal microecology and acute respiratory distress syndrome
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Selective decontamination of the digestive tract: time to implement it in all UK intensive care units? Maybe not yet
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2B or Not 2B for Selective Decontamination of the Digestive Tract in the Surviving Sepsis Campaign Guidelines
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Targeting Gut–Lung Crosstalk in Acute Respiratory Distress Syndrome: Exploring the Therapeutic Potential of Fecal Microbiota Transplantation
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Descontaminación digestiva del tracto digestivo: concepto y aplicación
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Selective digestive tract decontamination in the intensive care unit: Life saver or recipe for disaster?
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Reducing Mortality in the Perioperative Period
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Multiple Organ Dysfunction Syndrome
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Parenteral antibiotics are not enough to prevent pneumonia in stroke
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Inappropriate Dose of Enteral Antimicrobials Promotes Resistance
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Targeted dosing for susceptible heteroresistant subpopulations may improve rational dosage regimen prediction for colistin in broiler chickens
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Visualizing and diagnosing spillover within randomized concurrent controlled trials through the application of diagnostic test assessment methods
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Sepsis and Organ(s) Dysfunction
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Ventilator-associated pneumonia prevention: the issue is the control of oropharyngeal and gut overgrowth
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Selective digestive decontamination and bacterial resistance
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Antimicrobial resistance in intensive care units
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Structural Equation Modelling as a Proof-of-Concept Tool for Mediation Mechanisms Between Topical Antibiotic Prophylaxis and Six Types of Blood Stream Infection Among ICU Patients
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Vitamin K and Parenteral Nutrition
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Selective Decontamination of the Digestive Tract (SDD)
Rommes, H. J., van Saene, R., & de la Cal, M. A. (2021) · Springer eBooks · doi:10.1007/978-3-030-65225-8 · Cited by 3 · see citing works
From SDD to a risk- and CIRCO-diagnosis-based approach for treatment and prophylaxis of intestinal bacterial overgrowth in critically ill patients
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What is new in infection prevention in critical care in 2014?
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Inflammation and Hyperinflammation
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Selective Decontamination of the Digestive Tract
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Usages de la colistine en médecine humaine et vétérinaire : exploration pharmacocinétique et problématique d'antibiorésistance
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Selective Decontamination of the Digestive Tract
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Infektionsprävention in der Intensivmedizin
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Geschichtliche Entwicklung und Public-Health-Aspekte
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Wichtige Antibiotikaindikationen und Krankheitsbilder unter ASB-Gesichtspunkten
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Inoculation and Culturing
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Selective Decontamination of the Digestive Tract
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Decolonization Strategies To Control Aerobic Gram-Negative Bacillary Infections in Breast Implant Surgery
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Oropharyngeal without intestinal decontamination does not make sense
Damjanovic, V., Silvestri, L., Taylor, N., van Saene, H. K. F., & Piacente, N. (2014) · Journal of Hospital Infection · doi:10.1016/j.jhin.2013.11.011 · Cited by 1 · see citing works
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Trauma patients requiring treatment on the intensive care unit ( ICU ) need antimicrobial prophylaxis to prevent pneumonia
Zandstra, D. F., van Saene, H. K. F., & Strinnholm, M. (2014) · Acta Anaesthesiologica Scandinavica · doi:10.1111/aas.12365
Preventing infection in the intensive care unit: targeted or universal decolonization.
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Infektionsprävention in der Intensivmedizin
Schulz-Stübner, S. (2013) · Springer eBooks · doi:10.1007/978-3-642-36864-6_22
The innovative microbiology of selective digestive decontamination requires a new mindset - Letter to the editor
Rommes, J. H., Bakker, J., Spronk, P. E., Zandstra, D. F., & van Saene, H. K. (2014) · EUR Research Repository (Erasmus University Rotterdam)
Geschichtliche Entwicklung, Public-Health-Aspekte und allgemeine Hygienemaßnahmen
Schulz-Stübner, S. (2019) · Springer eBooks · doi:10.1007/978-3-662-58213-8_1
Randomized clinical trial of glutamine-supplemented versus standard parenteral nutrition in infants with surgical gastrointestinal disease (Br J Surg 2012; 99: 929–938)
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Asymmetric Effects of Decontamination Using Topical Antibiotics for the ICU Patient
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Risk factors of ventilator-associated pneumonia in children in an Egyptian University Children’s Hospital
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Infektionsprävention in der Intensivmedizin
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Infektionsprävention in der Intensivmedizin
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Gut instinct
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Intestinal Dysmotility of Critical Illness
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Intestinal Dysmotility of Critical Illness
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Infection Control
Rommes, H. J., van Saene, R., & de la Cal, M. A. (2021) · Springer eBooks · doi:10.1007/978-3-030-65225-8_5
Intestinal rehabilitation in critical illness
Wu, X., Ren, J., Li, S., Liu, P., Liu, Y., & Huang, J. (2022) · World Journal of Surgical Infection · doi:10.4103/wjsi.wjsi_7_22
The Microbiome in Critically Ill Patients
Tulli, G., & Zuanetti, G. (2022) · Springer eBooks · doi:10.1007/978-3-031-14612-1_7
Praktische Infektionsprävention in speziellen Bereichen
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The Role of Selective Drug Therapy in Reducing Mortality in the High-risk Surgical Patients (Tranexamic Acid, Selective Bowel Tract Decontamination, Levosimendan, Beta-blockers, Insulin, Aprotinin, and Statins)
Landoni, G., Redaelli, M. B., & Zangrillo, A. (2023) · Springer eBooks · doi:10.1007/978-3-031-17273-1_35
Geschichtliche Entwicklung, Public-Health-Aspekte und allgemeine Hygienemaßnahmen
Schulz-Stübner, S. (2023) · Springer eBooks · doi:10.1007/978-3-662-65708-9_1
Effects of the Selective Decontamination of the Digestive Tract (SDD) on Pulmonary Secondary Infections in Patients with COVID-19 Acute Respiratory Distress Syndrome: A Retrospective Single Centre Experience
Berlot, G., Moro, E., Zio, S., Zanchi, S., Randino, A., & Tomasini, A. (2023) · Gastrointestinal Disorders · doi:10.3390/gidisord5020019
Wichtige Antibiotikaindikationen und Krankheitsbilder unter ASB-Gesichtspunkten
Schulz-Stübner, S. (2024) · Springer eBooks · doi:10.1007/978-3-662-68836-6_11

Selective decontamination of the digestive tract: concept and application
Álvarez, E. E. T., & López, M. Á. D. L. C. (2023) · Medicina Intensiva (English Edition) · doi:10.1016/j.medine.2023.05.018 · Cited by 8 · see citing works
Selective Decontamination of the Digestive Tract
Silvestri, L., & van Saene, H. K. F. (2013) · Springer eBooks · doi:10.1007/978-3-319-02186-7_14 · Cited by 1 · see citing works
Self-citation
Antibiotic resistance associated with selective decontamination of the digestive tract
Webb, C. H. (1992) · Journal of Hospital Infection · doi:10.1016/0195-6701(92)90125-6 · Cited by 24 · see citing works
Antimicrobial Resistance
Taylor, N. F., Puch, I. C., Silvestri, L., Zandstra, D. F., & SAENE, H. K. F. V. (2011) · Springer eBooks · doi:10.1007/978-88-470-1601-9_28 · Cited by 2 · see citing works
Self-citation
Selective decontamination of the digestive tract (SDD) in intensive care patients: a critical evaluation of the clinical, bacteriological and epidemiological benefits
SAENE, H. K. F. V., Stoutenbeek, C. P., & Hart, C. A. (1991) · Journal of Hospital Infection · doi:10.1016/0195-6701(91)90184-a · Cited by 40 · see citing works

Authors: Silvestri, L., de la Cal, M. A., & van Saene, H. K. F.
Venue: Intensive Care Medicine
Publisher: Springer Science and Business Media LLC
Published: 2012-09-22
Volume: 38
Issue: 11
Pages: 1738-1750
ISSN: 0342-4642 (ISSN-L)
1432-1238
DOI: 10.1007/s00134-012-2690-1
OpenAlex: W2065187449
Cited by: 111
References: 156
Citations by year: 2026: 4 · 2025: 7 · 2024: 6 · 2023: 12 · 2022: 7 · 2021: 13 · 2020: 10 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 6 · 2015: 6 · 2014: 12 · 2013: 16
FWCI: 1.88
Type: journal article
Language: en
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Intensive Care Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Keywords: selective decontamination of the digestive tract, critically ill patients, antibiotic prophylaxis, lower respiratory tract infection, bloodstream infection, mortality, antimicrobial resistance, cefotaxime, polymyxins, tobramycin, vancomycin, methicillin-resistant Staphylococcus aureus, Candida, Staphylococcus aureus, endogenous infection
MeSH terms: Bacterial Infections, Carrier State, Decontamination, Digestive System, Gram-Negative Aerobic Bacteria, Humans, Meta-Analysis as Topic, Randomized Controlled Trials as Topic, Critical Illness, Antibiotic Prophylaxis

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Selective decontamination of the digestive tract: the mechanism of action is control of gut overgrowth

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