Pregledni rad
Gut overgrowth harms the critically ill patient requiring treatment on the intensive care unit
Hendrik Van Saene
; Institute of Ageing and Chronic Diseases, Duncan Building, University of Liverpool, UK
Luciano Silvestri
; Department of Emergency Unit of Anesthesia and Intensive Care, Presidio Ospedaliero, Gorizia, Italy
Nia Taylor
; Institute of Ageing and Chronic Diseases, Duncan Building, University of Liverpool
Durk Zandstra
; Intensive Care Unit, OLVG, Amsterdam, The Netherlands
Miguel De La Cal
; Department of Intensive Care Medicine, Hospital Universitario de Getafe, Carretera de Toledo, Getafe, Spain
Andy Petros
; Great Ormond Street Hospital for Children, NHS Trust, London
Sažetak
Overgrowth is defined as ≥105 potential pathogens per ml of saliva and/or per g of faeces. There are six 'normal' potential pathogens carried by healthy individuals and nine 'abnormal' potential pathogens carried by individuals with underlying disease both chronic and acute. Surveillance cultures of throat and/or rectum are required to identify overgrowth of 'normal' and/or 'abnormal' potential pathogens. There is a qualitative and quantitative relationship between surveillance samples and diagnostic samples of tracheal aspirate and blood, i.e., as soon as potential pathogens reach overgrowth concentrations in the surveillance samples, the diagnostic samples become positive for identical potential pathogens. Digestive tract decontamination aims at the eradication of overgrowth in order to prevent severe infections of lower airways and blood. Parenteral cefotaxime controls overgrowth of 'normal' bacteria, and enteral polyenes control overgrowth of 'normal' Candida species. Enteral polymyxin and tobramycin (with or without) vancomycin control 'abnormal' overgrowth.
Ključne riječi
overgrowth; 'normal' potential pathogens; 'abnormal' potential pathogens; surveillance samples; diagnostic samples; selective digestive decontamination (SDD)
Hrčak ID:
81723
URI
Datum izdavanja:
1.4.2012.
Posjeta: 1.271 *