BookHans Rommes, Rick van Saene, Miguel A. de la Cal.
Summary: This book explains the basic concepts of Selective Decontamination of the Digestive tract (SDD) to help those involved in treating critically ill patients to improve outcomes and the quality of care. SDD has led to major changes in our understanding, the treatment and prevention of infections in critically ill patients over the past 40 years. It is the most studied intervention in intensive care medicine and is the subject of 73 randomized controlled trials, including over 15000 patients and 15 meta-analyses. SDD reduces morbidity and mortality, is cost-effective and safe as SDD does not increase antimicrobial resistance. Correct application of the SDD strategy enables ICU teams to control infections - even in ICUs with endemic antibiotic resistant microorganisms such as methicillin resistant S. aureus (MRSA). Describing the concept and application of SDD, and presenting case studies and microbiological flow charts, this practical guide will appeal to intensivists, critical care practitioners, junior doctors, microbiologists and ICU-nurses as well as infection control specialists and pharmacists.
Contents:
Part I. The basics
Introduction
Microorganisms
Defense
Infections
Infection control
Enteral and parenteral antimicrobials used in the SDD-policy
Part II. Clinical microbiology for the ICU team
Clinical microbiology: an overview
Surveillance versus diagnostic cultures
Sampling and microscopy
Inoculation and culturing
Naming of microorganisms
Antibiotic sensitivity testing
Availability of the clinical microbiological results for the intensivist
Part III. Therapeutics
Therapy of bacterial and fungal infections
Viral infections in the ICU
Inflammation and hyperinflammation
Part IV. Surveillance
Resistance
Outbreaks
Appendix
Appendix 1. General principles before implementing the SDD-strategy
Appendix 2. Selective decontamination of the digestive tract
Appendix 3. SDD in Methicillin-resistant S. aureus (MRSA)
Appendix 4. SDD in Multidrug-resistant Gram-negative bacteria (MDRGNB).