Evidence map›Paper›PMID 38253478›Full record

Trial reportGut2024

Short-duration selective decontamination of the digestive tract infection control does not contribute to increased antimicrobial resistance burden in a pilot cluster randomised trial (the ARCTIC Study).

Iain Robert Louis Kean, John A Clark, Zhenguang Zhang, Esther Daubney, Deborah White, Paloma Ferrando-Vivas, Gema Milla, Brian Cuthbertson, John Pappachan, Nigel Klein and 8 more

Open access · hybridAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Gut, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.0field-weighted citation impact, top 10% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. MicroencapsulatedFrontiers in cellular and infection microbiology · 2026
    Article
  3. Article
  4. Update on infection prevention in the ICU.Current opinion in critical care · 2025
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 7 institutions in 3 countries.

Iain Robert Louis KeanDepartment of Paediatrics, University of Cambridge, Cambridge, UK.ORCID 0000-0003-1066-8285
John A ClarkDepartment of Paediatrics, University of Cambridge, Cambridge, UK.ORCID 0000-0001-6916-9195
Zhenguang ZhangDepartment of Paediatrics, University of Cambridge, Cambridge, UK.
Esther DaubneyCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Deborah WhiteCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Paloma Ferrando-VivasICNARC, London, UK.
Gema MillaICNARC, London, UK.
Brian CuthbertsonSunnybrook Hospital, Toronto, Ontario, Canada.
John PappachanUniversity of Southampton, Southampton, UK.
Nigel KleinUniversity College London, London, UK.
Paul MounceyICNARC, London, UK.
Kathy RowanICNARC, London, UK.
John MyburghThe George Institute for Global Health, Newtown, New South Wales, Australia.
Theodore GouliourisCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Stephen BakerDepartment of Medicine, University of Cambridge, Cambridge, UK.
Julian ParkhillDepartment of Veterinary Medicine, University of Cambridge, Cambridge, UK.
Nazima PathanDepartment of Paediatrics, University of Cambridge, Cambridge, UK np409@cam.ac.uk.ORCID 0000-0002-9447-4252
Arctic Research TeamARCTIC research team, Cambridge, UK.
University of Cambridge · GBIntensive Care National Audit & Research Centre · GBCambridge University Hospitals NHS Foundation Trust · GBSunnybrook Hospital · CAThe George Institute for Global Health · AUUniversity College London · GBUniversity of Southampton · GB

Funding

Medical Research UK GN2751Wellcome TrustWellcome Trust 215515/Z/19/Z
6 · The paper itself

Abstract

objectiveSelective decontamination of the digestive tract (SDD) is a well-studied but hotly contested medical intervention of enhanced infection control. Here, we aim to characterise the changes to the microbiome and antimicrobial resistance (AMR) gene profiles in critically ill children treated with SDD-enhanced infection control compared with conventional infection control.

designWe conducted shotgun metagenomic microbiome and resistome analysis on serial oropharyngeal and faecal samples collected from critically ill, mechanically ventilated patients in a pilot multicentre cluster randomised trial of SDD. The microbiome and AMR profiles were compared for longitudinal and intergroup changes. Of consented patients, faecal microbiome baseline samples were obtained in 89 critically ill children. Additionally, samples collected during and after critical illness were collected in 17 children treated with SDD-enhanced infection control and 19 children who received standard care.

resultsSDD affected the alpha and beta diversity of critically ill children to a greater degree than standard care. At cessation of treatment, the microbiome of SDD patients was dominated by Actinomycetota, specifically

conclusionShort interventions of SDD caused a shift in the microbiome but not of the AMR gene pool in critically ill children at the end mechanical ventilation, compared with standard antimicrobial therapy.

Indexed as

Critical IllnessDecontaminationFecesAnti-Bacterial AgentsChildChild, PreschoolDrug Resistance, BacterialFemaleGastrointestinal MicrobiomeGastrointestinal TractHumansInfantInfection ControlMaleOropharynxPilot ProjectsAnti-Bacterial AgentsANTIBIOTIC THERAPYDRUG RESISTANCE

Identifiers

PMID38253478
PMCPMC11103307
OpenAlexW4391097386

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.