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Cited by 469Nosocomial Infections in ICUPneumonia and Respiratory InfectionsAirway Management and Intubation Techniques

Aspiration of gastric bacteria in antacid-treated patients: a frequent cause of postoperative colonisation of the airway

DUMOULIN, G·1982·The Lancet
DOI 10.1016/s0140-6736(82)90974-6
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Abstract

The gastric and upper-airway flora of 60 consecutive patients treated with antacids or cimetidine in a respiratory/surgical intensive-therapy unit were studied. In 52 (87.0%) patients one or more organisms were cultured simultaneously from both upper airway and stomach. A sequence of transmission was clear in 17 of these patients. Pneumonia due to gram-negative bacilli developed in 31 patients; in most cases the causative organisms were of gastric origin. No pneumonia developed in the 8 patients whose gastric and upper-airway flora were different. The number of gram-negative bacilli in gastric aspirates correlated with the pH of the gastric aspirate. Treatment of seriously ill patients with antacids or cimetidine may encourage airway colonisation and predispose the patients to pneumonia caused by gram-negative bacilli.

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Crossref · 10.1016/s0140-6736(82)90974-6

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17 of 17 references verified0 citation errors · 0 not checkable

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  • Almost every common clinical intervention used in intensive care changes environmental growth conditions for intestinal bacteria.

    “Almost every common clinical intervention used in intensive care (eg, enteral feeding,43 proton-pump inhibitors,38,39 systemic catecholamines,22,23 and systemic antibiotics65,66) changes environmental growth conditions for intestinal bacteria”

    From The microbiome and critical illness (2016) · cites this paper as [39]

  • In the stomach of critically ill patients, transit time slows and pH is neutralised by the use of agents that suppress gastric acid production.

    “In the stomach, which is normally fast to empty and extremely acidic, transit time slows36 and pH is neutralised by the use of agents to suppress the production of gastric acid.”

    From The microbiome and critical illness (2016) · cites this paper as [39]

  • The virulence of pathogens familiar in intensive care is promoted by conditions of nutrient scarcity, competition from neighbouring community members, disruption of stabilising commensal relationships, and exposure to the mediators of the host stress response.

    “The virulence of pathogens familiar in intensive care is promoted by conditions of nutrient scarcity, competition from neighbouring community members, disruption of stabilising commensal relationships,20 and exposure to the mediators of the host stress response”

    From The microbiome and critical illness (2016) · cites this paper as [39]

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Authors
DUMOULIN, G.
Affiliations
Harvard University (US)
Corresponding author
DUMOULIN, G
Venue
The Lancet
Publisher
Elsevier BV
Published
1982-01
Volume
319
Issue
8266
Pages
242-245
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(82)90974-6
OpenAlex
W1480105763
Cited by
468
References
17
Citations by year
2025: 3 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 3 · 2016: 8 · 2015: 4 · 2014: 1 · 2013: 8 · 2012: 7
FWCI
15.81
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
  • Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
Keywords
antacids, cimetidine, Gram-negative bacilli, aspiration pneumonia, critically ill patients, intensive care
MeSH terms
Antacids, Bacteria, Bacterial Infections, Gastroesophageal Reflux, Gram-Negative Aerobic Bacteria, Gram-Negative Anaerobic Bacteria, Humans, Intensive Care Units, Pneumonia, Pneumonia, Aspiration, Postoperative Complications, Respiratory Insufficiency, Stomach, Trachea

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