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Preventing Infection Using Selective Decontamination of the Digestive Tract

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Infection Control in the Intensive Care Unit

Abstract

Selective decontamination of the digestive tract is an antimicrobial prophylaxis designed to prevent or minimize endogenous and exogenous infections in critically ill patients. The purpose of SDD is to prevent—or eradicate if initially present—the oropharyngeal and intestinal abnormal carrier state of potentially pathogenic microorganisms, mainly aerobic Gram-negative microorganisms, but also methicillin-sensitive Staphylococcus aureus (MSSA), and yeasts, leaving the indigenous flora predominately undisturbed.

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References

  1. Stoutenbeek CP, van Saene HKF, Miranda DR, Zandstra DF (1984) The effect of selective decontamination of the digestive tract on colonization and infection rate in multiple trauma patients. Intensive Care Med 10:185–192

    Article  PubMed  CAS  Google Scholar 

  2. van Saene HKF, Petros AJ, Ramsay G, Baxby D (2003) All great truths are iconoclastic: selective decontamination of the digestive tract moves from heresy to level 1 truth. Intensive Care Med 29:677–690

    PubMed  Google Scholar 

  3. Abdel-Razek SM, Abdel-Khalek AH, Allam AM et al (2000) Impact of selective gastrointestinal decontamination on mortality and morbidity in severely burned patients. Ann Burns Fire Disasters 13:213–215

    Google Scholar 

  4. Abele-Horn M, Dauber A, Bauernfeind A et al (1997) Decrease in nosocomial pneumonia in ventilated patients by selective oropharyngeal decontamination (SOD). Intensive Care Med 23:1878–1895

    Article  Google Scholar 

  5. Aerdts SJA, van Dalen R, Clasener HAL et al (1991) Antibiotic prophylaxis of respiratory tract infection in mechanically ventilated patients. A prospective, blinded, randomized trial of the effect of a novel regimen. Chest 100:783–791

    Article  PubMed  CAS  Google Scholar 

  6. Arnow PA, Caradang GC, Zabner R et al (1996) Randomized controlled trial of selective decontamination for prevention of infections following liver transplantation. Clin Infect Dis 22:997–1003

    Article  PubMed  CAS  Google Scholar 

  7. Barret JP, Jeschke MG, Herndon DN (2001) Selective decontamination of the digestive tract on severely burned pediatric patients. Burns 27:439–445

    Article  PubMed  CAS  Google Scholar 

  8. Bergmans DCJJ, Bonten MJM, Gaillard CA et al (2001) Prevention of ventilator-associated pneumonia by oral decontamination. A prospective, randomized, double-blind, placebo-controlled study. Am J Respir Crit Care Med 164:382–388

    PubMed  CAS  Google Scholar 

  9. Bion JF, Badger I, Crosby HA et al (1994) Selective decontamination of the digestive tract reduces Gram-negative pulmonary colonization but not systemic endotoxemia in patients undergoing elective liver transplantation. Crit Care Med 22:40–49

    PubMed  CAS  Google Scholar 

  10. Blair P, Rowlands BJ, Lowry K et al (1991) Selective decontamination of the digestive tract: a stratified, randomized, prospective study in a mixed intensive care unit. Surgery 110:303–310

    PubMed  CAS  Google Scholar 

  11. Boland JP, Sadler DL, Stewart W et al (1991) Reduction of nosocomial respiratory tract infections in the multiple trauma patients requiring mechanical ventilation by selective parenteral and enteral antisepsis regimen (SPEAR) in the intensive care [abstract]. 17th congress of chemotherapy, Berlin, N°0465

    Google Scholar 

  12. Bouter H, Schippers EF, Luelmo SAG et al (2002) No effect of preoperative selective gut decontamination on endotoxemia and cytokine activation during cardiopulmonary bypass: a randomized, placebo-controlled study. Crit Care Med 30:38–43

    Article  PubMed  CAS  Google Scholar 

  13. Brun-Buisson C, Legrand P, Rauss A et al (1989) Intestinal decontamination for control of nosocomial multiresistant gram-negative bacilli. Study of an outbreak in an intensive care unit. Ann Intern Med 110:873–881

    PubMed  CAS  Google Scholar 

  14. Camus C, Bellisant E, Sebille V et al (2005) Prevention of acquired infections in intubated patients with the combination of two decontamination regimens. Crit Care Med 33:307–314

    Article  PubMed  Google Scholar 

  15. Cerra FB, Maddaus MA, Dunn DL et al (1992) Selective gut decontamination reduces nosocomial infections and length of stay but not mortality or organ failure in surgical intensive care unit patients. Arch Surg 127:163–169

    Article  PubMed  CAS  Google Scholar 

  16. Cockerill FR, Muller SR, Anhalt JP et al (1992) Prevention of infection in critically ill patients by selective decontamination of the digestive tract. Ann Intern Med 117:545–553

    PubMed  Google Scholar 

  17. de Jonge E, Schultz M, Spanjaard L et al (2003) Effects of selective decontamination of the digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial. Lancet 363:1011–1016

    Article  Google Scholar 

  18. de la Cal MA, Cerdà E, Garcia-Hierro P et al (2005) Survival benefit in critically ill burned patients receiving selective decontamination of the digestive tract. A randomized, placebo-controlled, double-blind trial. Ann Surg 241:424–430

    Article  PubMed  Google Scholar 

  19. de Smet AMGA, Kluytmans JA, Cooper BS et al (2009) Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med 360:20–31

    Article  PubMed  Google Scholar 

  20. Diepenhorst GMP, van Ruler O, Besselink MGH et al (2011) Influence of prophylactic probiotics and selective decontamination on bacterial translocation in patients undergoing pancreatic surgery. Shock 35:9–16

    Article  PubMed  Google Scholar 

  21. Farran L, Llop J, Sans M et al (2008) Efficacy of enteral decontamination in the prevention of anastomotic dehiscence and pulmonary infection in esophagogastric surgery. Dis Esophagus 21:159–164

    Article  PubMed  CAS  Google Scholar 

  22. Ferrer M, Torres A, Gonzalez J et al (1994) Utility of selective decontamination in mechanically ventilated patients. Ann Intern Med 120:389–395

    PubMed  CAS  Google Scholar 

  23. Finch RG, Tomlinson P, Holliday M et al (1991) Selective decontamination of the digestive tract (SDD) in the prevention of secondary sepsis in a medical/surgical intensive care unit [abstract]. 17th congress of chemotherapy, Berlin, N°0471

    Google Scholar 

  24. Flaherty J, Nathan C, Kabins SA et al (1990) Pilot trial of selective decontamination for prevention of bacterial infection in an intensive care unit. J Infect Dis 162:1393–1397

    Article  PubMed  CAS  Google Scholar 

  25. Gastinne H, Wolff M, Delatour F et al (1992) A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics. N Engl J Med 326:594–959

    Article  PubMed  CAS  Google Scholar 

  26. Gaussorgues Ph, Salord F, Sirodot M et al (1991) Efficacité de la décontamination digestive sur la survenue des bactériémies nosocomiales chez les patients sous ventilation mécanique et recevant des bêtamimétiques. Réanimation Soins Intensive et Médicine d’Urgence 7:169–174

    Google Scholar 

  27. Georges B, Mazerolles M, Decun J-F et al (1994) Decontamination digestive selective: resultats d’une etude chez le polytraumatise. Reanim Urgences 3:621–627

    Article  Google Scholar 

  28. Gosney M, Martin MV, Wright AE (2006) The role of selective decontamination of the digestive tract in acute stroke. Age Aging 35:42–47

    Article  CAS  Google Scholar 

  29. Hammond JMJ, Potgieter PD, Saunders GL et al (1992) Double-blind study of selective decontamination of the digestive tract in intensive care. Lancet 340:5–9

    Article  PubMed  CAS  Google Scholar 

  30. Hellinger WC, Yao JD, Alvarez S et al (2002) A randomized, prospective, double blinded evaluation of selective bowel decontamination in liver transplantation. Transplantation 73:1904–1909

    Article  PubMed  Google Scholar 

  31. Jacobs S, Foweraker JE, Roberts SE (1992) Effectiveness of selective decontamination of the digestive tract (SDD) in an ICU with a policy encouraging a low gastric pH. Clin Intensive Care 3:52–58

    Google Scholar 

  32. Kerver AJH, Rommes JH, Mevissen-Verhage EAE et al (1988) Prevention of colonization and infection in critically ill patients: a prospective randomized study. Crit Care Med 16:1087–1093

    Article  PubMed  CAS  Google Scholar 

  33. Korinek AM, Laisne MJ, Nicolas MH et al (1993) Selective decontamination of the digestive tract in neurosurgical intensive care unit patients: a double-blind, randomized, placebo-controlled study. Crit Care Med 21:1466–1473

    Article  PubMed  CAS  Google Scholar 

  34. Krueger WA, Lenhart F-P, Neeser G et al (2002) Influence of combined intravenous and topical antibiotic prophylaxis on the incidence of infections, organ dysfunctions, and mortality in critically ill surgical patients. A prospective, stratified, randomized, double-blind, placebo-controlled clinical trial. Am J Respir Crit Care Med 166:1029–1037

    Article  PubMed  Google Scholar 

  35. Laggner AN, Tryba M, Georgopulos A et al (1994) Oropharyngeal decontamination with gentamicin for long-stay ventilated patients on stress ulcer prophylaxis with sucralfate? Wien Klin Wochenschr 106:15–19

    PubMed  CAS  Google Scholar 

  36. Lingnau W, Berger J, Javorsky F et al (1997) Selective intestinal decontamination in multiple trauma patients: prospective, controlled trial. J Trauma 42:687–694

    Article  PubMed  CAS  Google Scholar 

  37. Luiten EJT, Hop WCJ, Lange JF et al (1995) Controlled clinical trial of selective decontamination for the treatment of severe acute pancreatitis. Ann Surg 222:57–65

    Article  PubMed  CAS  Google Scholar 

  38. Martinez-Pellus AE, Merino P, Bru M et al (1993) Can selective digestive decontamination avoid the endotoxemia and cytokine activation promoted by cardiopulmonary bypass? Crit Care Med 21:1684–1691

    Article  PubMed  CAS  Google Scholar 

  39. Martinez-Pellus AE, Merino P, Bru M et al (1997) Endogenous endotoxemia of intestinal origin during cardiopulmonary bypass. Role of type of flow and protective effect of selective digestive decontamination. Intensive Care Med 23:1251–1257

    Article  PubMed  CAS  Google Scholar 

  40. Oudhuis GJ, Bergmans DG, Dormans T et al (2011) Probiotics versus antibiotic decontamination of the digestive tract: infection and mortality. Intensive Care Med 37:110–117

    Article  PubMed  Google Scholar 

  41. Palomar M, Alvarez-Lerma F, Jordà R et al (1997) Prevention of nosocomial infection in mechanically ventilated patients: selective digestive decontamination versus sucralfate. Clin Intensive Care 8:228–235

    Article  Google Scholar 

  42. Pneumatikos I, Koulouras V, Nathanail C et al (2002) Selective decontamination of subglottic area in mechanically ventilated patients with multiple trauma. Intensive Care Med 28:432–437

    Article  PubMed  Google Scholar 

  43. Pugin J, Auckenthaler R, Lew DP et al (1991) Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia. A randomized, placebo-controlled, double-blind clinical trial. JAMA 265:2704–2710

    Article  PubMed  CAS  Google Scholar 

  44. Quinio B, Albanese J, Bues-Charbit M et al (1996) Selective decontamination of the digestive tract in multiple trauma patients. A prospective double-blind, randomized, placebo-controlled study. Chest 109:765–772

    Article  PubMed  CAS  Google Scholar 

  45. Rayes N, Seehofer D, Hansen S et al (2002) Early enteral supply of Lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients. Transplantation 74:123–128

    Article  PubMed  Google Scholar 

  46. Rios F, Maskin B, Saenz Valliente A et al (2005) Prevention of ventilation associated pneumonia (VAP) by oral decontamination (OD). Prospective, randomized, double blind, placebo-controlled study. ATS interventional conference, San Diego, USA, C95, Poster 608 (abstract) available at http://abstracts2view.com/ats05/view.php?nu=ATS5L-3301

  47. Rocha LA, Martin MJ, Pita S et al (1993) Prevention of nosocomial infection in critically ill patients by selective decontamination of the digestive tract. A randomized, double-blind, placebo controlled study. Intensive Care Med 18:398–404

    Article  Google Scholar 

  48. Rodriguez-Roldan JM, Altuna-Cuesta A, Lopez A et al (1990) Prevention of nosocomial lung infection in ventilated patients: use of an antimicrobial pharyngeal nonabsorbable paste. Crit Care Med 18:1239–1242

    Article  PubMed  CAS  Google Scholar 

  49. Rolando N, Gimson A, Wade J et al (1993) Prospective controlled trial of selective parenteral and enteral antimicrobial regimen in fulminant liver failure. Hepatology 17:196–201

    Article  PubMed  CAS  Google Scholar 

  50. Rolando N, Wade JJ, Stangou A et al (1996) Prospective study comparing the efficacy of prophylactic parenteral antimicrobials. With or without enteral decontamination, in patients with acute liver failure. Liver Transpl Surg 2:8–13

    Article  PubMed  CAS  Google Scholar 

  51. Ruza F, Alvarado F, Herruzo R et al (1998) Prevention of nosocomial infection in a pediatric intensive care unit (PICU) through the use of selective digestive decontamination. Eur J Epidemiol 14:719–727

    Article  PubMed  CAS  Google Scholar 

  52. Sanchez Garcia M, Cambronero Galache JA, Lopez Diaz J et al (1998) Effectiveness and cost of selective decontamination of the digestive tract in critically ill intubated patients. A randomized, double-blind, placebo-controlled, multicenter trial. Am J Respir Crit Care Med 158:908–916

    PubMed  CAS  Google Scholar 

  53. Schardey HM, Joosten U, Finke U et al (1997) The prevention of anastomotic leakage after total gastrectomy with local decontamination. A prospective, randomized, double-blind, placebo-controlled, multicenter trial. Ann Surg 225:172–180

    Article  PubMed  CAS  Google Scholar 

  54. Smith SD, Jackson RJ, Hannakan CJ et al (1993) Selective decontamination in pediatric liver transplants. A randomized prospective study. Transplantation 55:1306–1309

    Article  PubMed  CAS  Google Scholar 

  55. Stoutenbeek CP, van Saene HKF, Zandstra DF (1996) Prevention of multiple organ failure by selective decontamination of the digestive tract in multiple trauma patients. In: Faist E, Baue AE, Schildberg FW (eds) The immune consequences of trauma, shock and sepsis–mechanisms and therapeutic approach. Pabst Science Publishers, Lengerich, pp 1055–1066

    Google Scholar 

  56. Stoutenbeek CP, van Saene HKF, Little RA et al (2007) The effect of selective decontamination of the digestive tract on mortality in multiple trauma patients: a multicenter randomized controlled trial. Intensive Care Med 33:261–270

    Article  PubMed  CAS  Google Scholar 

  57. Tetteroo GWM, Wagenvoort JHT, Castelein A et al (1990) Selective decontamination to reduce gram-negative colonisation and infections after oesophageal resection. Lancet 335:704–707

    Article  PubMed  CAS  Google Scholar 

  58. Ulrich C, Harinck-de Weerd JE, Bakker NC et al (1989) Selective decontamination of the digestive tract with norfloxacin in the prevention of ICU-acquired infections: a prospective randomized study. Intensive Care Med 15:424–431

    Article  PubMed  CAS  Google Scholar 

  59. Unertl K, Ruckdeschel G, Selbmann HK et al (1987) Prevention of colonization and respiratory infections in long-term ventilated patients by local antimicrobial prophylaxis. Intensive Care Med 13:106–113

    Article  PubMed  CAS  Google Scholar 

  60. Verwaest C, Verhaegen J, Ferdinande P et al (1997) Randomized, controlled trial of selective digestive decontamination in 600 mechanically ventilated patients in a multidisciplinary intensive care unit. Crit Care Med 25:63–71

    Article  PubMed  CAS  Google Scholar 

  61. Wiener J, Itokazu G, Nathan C et al (1995) Randomized, double-blind, placebo-controlled trial of selective digestive decontamination in a medical-surgical intensive care unit. Clin Infect Dis 20:861–867

    Article  PubMed  CAS  Google Scholar 

  62. Winter R, Humphreys H, Pick A et al (1992) A controlled trial of selective decontamination of the digestive tract in intensive care and its effect on nosocomial infection. J Antimicrob Chemother 30:73–77

    Article  PubMed  CAS  Google Scholar 

  63. Yu J, Xiao YB, Wang XY (2007) Effects of preoperatively selected gut decontamination on cardiopulmonary bypass-induced endotoxemia. Chin J Traumatol 10:131–137

    PubMed  CAS  Google Scholar 

  64. Zobel G, Kutting M, Grubbauer H-M et al (1991) Reduction of colonization and infection rate during pediatric intensive care by selective decontamination of the digestive tract. Crit Care Med 19:1242–1246

    Article  PubMed  CAS  Google Scholar 

  65. Zwaveling JH, Maring JK, Klompmaker IJ et al (2002) Selective decontamination of the digestive tract to prevent postoperative infection: a randomized placebo-controlled trial in liver transplant patients. Crit Care Med 30:1204–1209

    Article  PubMed  Google Scholar 

  66. Vandenbroucke-Grauls CMJ, Vandenbroucke JP (1991) Effect of selective decontamination of the digestive tract on respiratory tract infections and mortality in the intensive care unit. Lancet 338:859–862

    Article  PubMed  CAS  Google Scholar 

  67. D’Amico R, Pifferi S, Leonetti C et al (1998) Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials. BMJ 316:1275–1285

    Article  PubMed  Google Scholar 

  68. Liberati A, D’Amico R, Pifferi S et al (2004) Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database Syst Rev 1:CD000022

    Google Scholar 

  69. Safdar N, Said A, Lucey MR (2004) The role of selective digestive decontamination for reducing infection in patients undergoing liver transplantation: a systematic review and meta-analysis. Liver Transpl 10:817–827

    Article  PubMed  Google Scholar 

  70. Silvestri L, van Saene HKF, Milanese M et al (2005) Impact of selective decontamination of the digestive tract on fungal carriage and infection: systematic review of randomised controlled trials. Intensive Care Med 31:898–910

    Article  PubMed  Google Scholar 

  71. Silvestri L, van Saene HKF, Milanese M et al (2007) Selective decontamination of the digestive tract reduces bacterial bloodstream infections and mortality in critically ill patients. Systematic review of randomised, controlled trials. J Hosp Infect 15:187–203

    Article  Google Scholar 

  72. Silvestri L, van Saene HKF, Casarin A et al (2008) Impact of selective decontamination of the digestive tract on carriage and infection due to Gram-negative and Gram-positive bacteria. A systematic review of randomised controlled trials. Anaesth Intensive Care 36:324–338

    PubMed  CAS  Google Scholar 

  73. Silvestri L, van Saene HKF, Weir J, Gullo A (2009) Survival benefit of the full selective digestive decontamination regimen. J Crit Care 24:e7–e14

    Article  PubMed  Google Scholar 

  74. Liberati A, D’Amico R, Pifferi S et al (2009) Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database Syst Rev 4:CD000022

    Google Scholar 

  75. Silvestri L, van Saene HKF, Zandstra DF et al (2010) Impact of selective decontamination of the digestive tract on multiple organ dysfunction syndrome: systematic review of randomized controlled trials. Crit Care Med 38:1370–1376

    PubMed  Google Scholar 

  76. Silvestri L, van Saene HKF, Zandstra DF et al (2010) SDD, SOD or oropharyngeal chlorhexidine to prevent pneumonia and to reduce mortality in ventilated patients: which manoeuvre is evidence-based? Intensive Care Med 31:1436–1437

    Article  Google Scholar 

  77. Oostdijk EAN, de Smet AMGA, Kesecioglu J, Bonten MJM, on behalf of the Dutch SOD-SDD Trialsts Group (2011) The role of intestinal colonization with Gram negative bacteria as a source for intensive care unit-acquired bacteremia. Crit Care Med 39:961–966

    Google Scholar 

  78. Silvestri L, Milanese M, Taylor N et al (2010) Selective digestive decontamination reduces ventilator-associated tracheobronchitis. Respir Med 104:1953–1955

    Article  PubMed  Google Scholar 

  79. Silvestri L, de la Cal MA, Taylor N et al (2010) Selective decontamination of the digestive tract in burn patients: an evidence-based maneuver that reduces mortality. J Burn Care Res 31:372–373

    Article  PubMed  Google Scholar 

  80. Silvestri L, van Saene HKF (2010) Selective digestive decontamination to prevent pneumonia after esophageal surgery. Ann Thor Cardiovasc Surg 16(3):220–221

    CAS  Google Scholar 

  81. Silvestri L, van Saene HKF (2006) Selective decontamination of the digestive tract does not increase resistance in critically ill patient. Evidence from randomized controlled trials. Crit Care Med 34:2027–2029

    Article  PubMed  Google Scholar 

  82. de Smet AM, Kluytmans J, Blok H et al (2010) Effects of selective digestive and selective oropharyngeal decontamination on bacteraemia and respiratory tract colonization with highly resistant micro-organisms. Clin Microbiol Infect 16(suppl 2):S98

    Google Scholar 

  83. Oodstijk EAN, de Smet AMGA, Blok HEM et al (2010) Ecological effects of selective decontamination on resistant Gram-negative bacterial colonization. Am J Respir Crit Care Med 181:452–457

    Article  Google Scholar 

  84. Zandstra DF, Petros AJ, Taylor N et al (2010) Withholding selective decontamination of the digestive tract from critically ill patients must now surely be ethically questionable given the vast evidence base. Crit Care 14:443

    Article  PubMed  Google Scholar 

  85. Petros AJ, Taylor N, V Damjanovic et al (2010) Worlds apart; proof that SDD works. Am J Respir Crit Care Med 182:1564

    PubMed  Google Scholar 

  86. Silvestri L, Milanese M, Oblach L et al (2002) Enteral vancomycin to control methicillin-resistant Staphylococcus aureus outbreak in mechanically ventilated patients. Am J Infect Control 30:391–399

    Article  PubMed  Google Scholar 

  87. de la Cal MA, Cerdà E, van Saene HKF et al (2004) Effectiveness and safety of enteral vancomycin to control endemicity of methicillin-resistant Staphylococcus aureus in a medical/surgical intensive care unit. J Hosp Infect 56:175–183

    Article  Google Scholar 

  88. Bhorade SM, Christensen J, Pohlman AS et al (1999) The incidence of and clinical variables associated with vancomycin-resistant enterococcal colonization in mechanically ventilated patients. Chest 115:1085–1091

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Emergency, Unit of Anesthesia and Intensive Care, Presidio Ospedaliero di Gorizia, Gorizia, Italy

    L. Silvestri

  2. Institute for Ageing and Chronic Disease, University of Liverpool, Liverpool, UK

    H. K. F. van Saene

  3. Intensive Care Unit, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands

    D. F. Zandstra

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  1. L. Silvestri
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  2. H. K. F. van Saene
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  3. D. F. Zandstra
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Correspondence to L. Silvestri .

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Editors and Affiliations

  1. , Institute of Aging and Chronic Diseases, University Liverpool, Daulby Street, Liverpool, L69 3GA, United Kingdom

    Hendrick K.F. van Saene

  2. , Dept. Emergency, Hospital Gorizia, Via Vittorio Veneto 171, Gorizia, 34170, Italy

    Luciano Silvestri

  3. , Department of Intensive Care Medicine, Hospital Universitario de Getafe, Carretera de Toledo km 12.5, Getafe, 28045, Spain

    Miguel A. de la Cal

  4. Policlinico di Catania, UCO di Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria, Via Santa Sofia 78, Catania, 95100, Italy

    Antonino Gullo

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Silvestri, L., van Saene, H.K.F., Zandstra, D.F. (2011). Preventing Infection Using Selective Decontamination of the Digestive Tract. In: van Saene, H., Silvestri, L., de la Cal, M., Gullo, A. (eds) Infection Control in the Intensive Care Unit. Springer, Milano. https://doi.org/10.1007/978-88-470-1601-9_13

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