Selective Digestive Decontamination: A Comprehensive Approach to Reducing Nosocomial Infections and Antimicrobial...

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Microbiology

Background:

• Multidrug-resistant (MDR) bacteria, particularly carbapenemase-producing Enterobacterale (CPE), are a major global health threat.
• Intensive care units (ICUs) experience high antibiotic consumption, driving antimicrobial resistance.
• Selective digestive decontamination (SDD) is a strategy to prevent nosocomial infections and MDR pathogen colonization.

Purpose of the Study:

• To evaluate the impact of an SDD protocol on antibiotic consumption.
• To assess the effect of SDD on CPE colonization rates in an ICU.
• To analyze changes in nosocomial infections and MDR bacteria incidence post-SDD implementation.

Main Methods:

• Quasi-experimental study in a university hospital ICU (June 2021-June 2023).
• Comparison of pre-intervention (no SDD) and post-intervention (SDD implemented) patient groups.
• Data collection on antibiotic consumption (DDDs/100 stays), infections, colonization, and MDR bacteria.

Main Results:

• SDD implementation led to a significant reduction in overall antibiotic consumption (p=0.028).
• Carbapenem use and CPE colonization rates significantly decreased post-SDD (p<0.01 and p=0.0099, respectively).
• A non-significant decrease in nosocomial infections was observed in the post-SDD group.

Conclusions:

• SDD protocol significantly reduced antibiotic consumption and CPE colonization in the ICU.
• SDD shows promise as a tool for managing antimicrobial resistance in critical care.
• The study suggests SDD does not contribute to the development of MDR bacteria.