Tetteroo G W, Wagenvoort J H, Bruining H A
Department of Surgery, University Hospital Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
Br J Surg. 1992 Apr;79(4):300-4. doi: 10.1002/bjs.1800790405.
Aspects of selective decontamination as an antibiotic prophylaxis in general surgery are discussed with respect to the respiratory tract and wound infection. The high rate of nosocomial infection encountered in surgical patients, who experience up to 71 per cent of all such infection, is considered. The infection rate increases to 70-80 per cent after 1 week in the surgical intensive care unit, while the infection-related mortality rate rises to up to 60 per cent. The endogenous origin of nosocomial infection suggests the importance of maintaining colonization resistance to prevent colonization with Gram-negative micro-organisms, especially using selective decontamination which eliminates potentially pathogenic micro-organisms while leaving colonization resistance intact. Selective decontamination has proved effective in decreasing infection rates by 50-80 per cent, and is especially successful in respiratory tract infection. Possible adverse effects and future indications for selective decontamination are discussed.
本文就选择性肠道去污作为普通外科抗生素预防措施的相关方面，探讨了其在呼吸道和伤口感染中的应用。文中考虑了外科手术患者中高达71%的医院感染发生率。在外科重症监护病房，患者入住1周后的感染率升至70%-80%，而与感染相关的死亡率则高达60%。医院感染的内源性起源表明，维持定植抵抗力以防止革兰氏阴性微生物定植非常重要，尤其是采用选择性肠道去污法，该方法可消除潜在致病微生物，同时保持定植抵抗力完整。选择性肠道去污已被证明可有效降低感染率50%-80%，在呼吸道感染方面尤其成功。文中还讨论了选择性肠道去污可能的不良反应及未来的应用指征。
