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Gut overgrowth harms the critically ill patient requiring treatment on the intensive care unit 

  • HENDRIK VAN SAEN1
  • LUCIANO SILVESTRI2
  • NIA TAYLOR3
  • DURK ZANDSTRA4
  • MIGUEL DE LA CAL5
  • ANDY PETROS6

1,Institute of Ageing and Chronic Diseases Duncan Building University of Liverpool

2,Department of Emergency Unit of Anesthesia and Intensive Care Presidio Ospedaliero

3Institute of Ageing and Chronic Diseases Duncan Building, University of Liverpool

4Intensive Care Unit, OLVG Amsterdam, The Netherlands

5,Department of Intensive Care Medicine Hospital Universitario de Getafe Carretera de Toledo

6,Great Ormond Street Hospital for Children NHS Trust

DOI: 10.22514/SV71.042012.1 Vol.7,Issue 1,April 2012 pp.7-9

Published: 30 April 2012

*Corresponding Author(s): HENDRIK VAN SAEN E-mail: nia.taylor@liv.ac.uk

Abstract

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 ’nor-mal’ and/or ‘abnormal’ potential pathogens. There is a qualitative and quantitative relationship between surveillance sam-ples and diagnostic samples of tracheal aspirate and blood, i.e., as soon as potential pathogens reach overgrowth concen-trations 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.

Keywords

overgrowth, ’normal’ potential pathogens, ’abnormal’ potential pathogens, surveillance samples, diagnostic samples, selec-tive digestive decontamination (SDD)

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HENDRIK VAN SAEN,LUCIANO SILVESTRI,NIA TAYLOR,DURK ZANDSTRA,MIGUEL DE LA CAL,ANDY PETROS. Gut overgrowth harms the critically ill patient requiring treatment on the intensive care unit . Signa Vitae. 2012. 7(1);7-9.

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