Observational studyCritical care (London, England)2019
The ecological effects of selective decontamination of the digestive tract (SDD) on antimicrobial resistance: a 21-year longitudinal single-centre study.
Observational study in Critical care (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effect of selective decontamination on antimicrobial resistance in intensive care patients: a systematic review and meta-analysis.Scientific reports · 2026Pooled it
- Trial
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- Effect of the implementation of a selective digestive decontamination protocol in an intensive care unit.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Article
- Oral nonabsorbable antibiotics for prevention of recurrent cholangitis; a brief report study.Infection · 2025Article
- Impact of Multifaceted Interventions Including Waterless Patient Care on Endemic Occurrence ofPathogens (Basel, Switzerland) · 2025Article
- Towards a holistic approach to pulmonary infections. Insights from the Sixth Annual Meeting of Spanish Experts 2024.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Review
- Gut Microbiota Metabolites Targeting the Immune Response in Sepsis: Mechanisms and Therapies.International journal of general medicine · 2025Review
- Structural Equation Modelling as a Proof-of-Concept Tool for Mediation Mechanisms Between Topical Antibiotic Prophylaxis and Six Types of Blood Stream Infection Among ICU Patients.Antibiotics (Basel, Switzerland) · 2024Review
- Selective digestive decontamination - Pro.Intensive care medicine · 2023Article
- Ecological effects of selective oral decontamination on multidrug-resistance bacteria acquired in the intensive care unit: a case-control study over 5 years.Intensive care medicine · 2022Article
- COVID-19 Secondary Infections in ICU Patients and Prevention Control Measures: A Preliminary Prospective Multicenter Study.Antibiotics (Basel, Switzerland) · 2022Article
- Enteral Vancomycin to Eliminate MRSA Carriership of the Digestive Tract in Critically Ill Patients.Antibiotics (Basel, Switzerland) · 2022Article
- A prospective matched case-control study on the genomic epidemiology of colistin-resistant Enterobacterales from Dutch patients.Communications medicine · 2022Article
- Selective Intestinal Decontamination as a Method for Preventing Infectious Complications (Review).Sovremennye tekhnologii v meditsine · 2021Review
- Eradication of Resistant and Susceptible Aerobic Gram-Negative Bacteria From the Digestive Tract in Critically Ill Patients; an Observational Cohort Study.Frontiers in microbiology · 2021Article
- Decreased duration of intravenous cephalosporins in intensive care unit patients with selective digestive decontamination: a retrospective before-and-after study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Observational
- Selective decontamination of the digestive tract (SDD) in critically ill patients: a narrative review.Intensive care medicine · 2020Review
- Impact of microbiome-based interventions on gastrointestinal pathogen colonization in the intensive care unit.Therapeutic advances in gastroenterology · 2020Review
- Attenuation of MODS-related and ARDS-related mortality makes infectious complications a remaining challenge in the severely injured.Trauma surgery & acute care open · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe long-term ecological effects on the emergence of antimicrobial resistance at the ICU level during selective decontamination of the digestive tract (SDD) are unknown. We determined the incidence of newly acquired antimicrobial resistance of aerobic gram-negative potentially pathogenic bacteria (AGNB) during SDD.
methodsIn a single-centre observational cohort study over a 21-year period, all consecutive patients, treated with or without SDD, admitted to the ICU were included. The antibiotic regime was unchanged over the study period. Incidence rates for ICU-acquired AGNB's resistance for third-generation cephalosporins, colistin/polymyxin B, tobramycin/gentamicin or ciprofloxacin were calculated per year. Changes over time were tested by negative binomial regression in a generalized linear model.
resultsEighty-six percent of 14,015 patients were treated with SDD. Most cultures were taken from the digestive tract (41.9%) and sputum (21.1%). A total of 20,593 isolates of AGNB were identified. The two most often found bacteria were Escherichia coli (N = 6409) and Pseudomonas (N = 5269). The incidence rate per 1000 patient-day for ICU-acquired resistance to cephalosporins was 2.03, for polymyxin B/colistin 0.51, for tobramycin 2.59 and for ciprofloxacin 2.2. The incidence rates for ICU-acquired resistant microbes per year ranged from 0 to 4.94 per 1000 patient-days, and no significant time-trend in incidence rates were found for any of the antimicrobials. The background prevalence rates of resistant strains measured on admission for cephalosporins, polymyxin B/colistin and ciprofloxacin rose over time with 7.9%, 3.5% and 8.0% respectively.
conclusionsDuring more than 21-year SDD, the incidence rates of resistant microbes at the ICU level did not significantly increase over time but the background resistance rates increased. An overall ecological effect of prolonged application of SDD by counting resistant microorganisms in the ICU was not shown in a country with relatively low rates of resistant microorganisms.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.