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Selective digestive tract decontamination and vancomycin-resistant enterococcus isolation in the surgical intensive
1Department of Surgery, University of Minnesota, Fairview-University Medical Center, Minneapolis 55455, USA.
Shock (Augusta, Ga.)
|October 12, 2000
Summary
Selective digestive tract decontamination (SDD) alone did not increase vancomycin-resistant Enterococcus (VRE) isolation in the surgical intensive care unit (SICU). However, SDD combined with vancomycin and ceftazidime showed a significant association with VRE.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Hospital Epidemiology
Background:
- Vancomycin-resistant Enterococcus (VRE) is a major cause of hospital-acquired infections, particularly in surgical intensive care units (SICUs).
- The role of selective digestive tract decontamination (SDD) in the emergence of VRE remains unclear.
Purpose of the Study:
- To investigate the association between the use of SDD and the incidence of VRE isolation in a SICU.
- To determine if specific antibiotic combinations including SDD influence VRE rates.
Main Methods:
- Retrospective review of SICU patient records from 1996-1999.
- Analysis of VRE colonization/infection, length of SICU stay, and use of SDD, vancomycin, and ceftazidime.
- Univariate and logistic regression analyses to assess associations.
Main Results:
- SDD use alone was not associated with increased VRE isolation.
- However, SDD in combination with vancomycin showed higher odds of VRE (OR=4.3 vs. 10.9).
- The combination of SDD, vancomycin, and ceftazidime demonstrated a significantly higher association with VRE isolation (OR=70.5 vs. 19.8).
Conclusions:
- Administration of SDD alone does not correlate with increased VRE isolation.
- The combination of SDD with vancomycin and ceftazidime is associated with a higher risk of VRE isolation in the SICU.