The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index.
Prevention of Ventilator-associated Pneumonia by Oral Decontamination: A Prospective, Randomized, Double-blind, Placebo-controlled Study
Abstract
UNLABELLED: Colonization of the intestinal tract has been assumed to be important in the pathogenesis of ventilator-associated pneumonia (VAP), but relative impacts of oropharyngeal, gastric, or intestinal colonization have not been elucidated. Our aim was to prevent VAP by modulation of oropharyngeal colonization, without influencing gastric and intestinal colonization and without systemic prophylaxis. In a prospective, randomized, placebo-controlled, double-blind study, 87 patients received topical antimicrobial prophylaxis (gentamicin/ colistin/vancomycin 2% in Orabase, every 6 h) in the oropharynx and 139 patients, divided over two control groups, received placebo (78 patients were studied in the presence of patients receiving topical prophylaxis [control group A] and 61 patients were studied in an intensive care unit where no topical prophylaxis was used [control group B]). Baseline characteristics were comparable in all three groups. Topical prophylaxis eradicated colonization present on admission in oropharynx (75% in study group versus 0% in control group A [p < 0.00001] and 9% in control group B patients [p < 0.00001]) and in trachea (52% versus 22% in A [p = 0.03] and 7% in B [p = 0.004]). Moreover, topical prophylaxis prevented acquired oropharyngeal colonization (10% versus 59% in A [p < 0.00001] and 63% in B [p < 0.00001]). Colonization rates in stomach and intestine were not affected. Incidences of VAP were 10% in study patients, 31% in Group A, and 23% in Group B patients (p = 0.001 and p = 0.04, respectively). This was not associated with shorter durations of ventilation or ICU stay or better survival. Oropharyngeal colonization is of paramount importance in the pathogenesis of VAP, and a targeted approach to prevent colonization at this site is a very effective method of infection prevention. KEYWORDS: cross infection, prevention and control; respiration, artificial, adverse effects; antibiotics, administration and dosage infection control methods; pneumonia, etiology, prevention and control; intubation, intratracheal, adverse effects
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Cited by
Melsen, W. G., Rovers, M. M., Groenwold, R. H., Bergmans, D. C., Camus, C., Bauer, T. T., Hanisch, E. W., Klarin, B., Koeman, M., Krueger, W. A., et al. (2013) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(13)70081-1 · Cited by 854
Self-citationDecontamination of the digestive tract and oropharynx in ICU patients
de Smet, A. M. G. A., Kluytmans, J. A. J. W., Cooper, B. S., Mascini, E. M., Benus, R. F. J., van der Werf, T. S., van der Hoeven, J. G., Pickkers, P., Bogaers-Hofman, D., van der Meer, N. J. M., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0800394 · Cited by 813
Self-citationSystematic Review of the Association Between Respiratory Diseases and Oral Health
Azarpazhooh, A., & Leake, J. L. (2006) · Journal of Periodontology · doi:10.1902/jop.2006.060010 · Cited by 641
de Jonge, E., Schultz, M. J., Spanjaard, L., Bossuyt, P. M., Vroom, M. B., Dankert, J., & Kesecioglu, J. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14409-1 · Cited by 587
The oral microbiota: Living with a permanent guest
Avila, M., Ojcius, D. M., & Yilmaz, Ö. (2009) · DNA and Cell Biology · doi:10.1089/dna.2009.0874 · Cited by 482
Metadata
- Authors
- BERGMANS, D. C. J. J., BONTEN, M. J. M., GAILLARD, C. A., PALING, J. C., van der GEEST, S., van TIEL, F. H., BEYSENS, A. J., de LEEUW, P. W., & STOBBERINGH, E. E.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-08-01
- Volume
- 164
- Issue
- 3
- Pages
- 382-388
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2138605025
- Cited by
- 339
- References
- 26
- FWCI
- 10.86
- Type
- journal article
- Language
- en
- Open access
- closed
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- BERGMANS, D. C. J. J., BONTEN, M. J. M., GAILLARD, C. A., PALING, J. C., van der GEEST, S., van TIEL, F. H., BEYSENS, A. J., de LEEUW, P. W., & STOBBERINGH, E. E. (2001). Prevention of Ventilator-associated Pneumonia by Oral Decontamination: A Prospective, Randomized, Double-blind, Placebo-controlled Study. American Journal of Respiratory and Critical Care Medicine. https://doi.org/10.1164/ajrccm.164.3.2005003
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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