Course ? Prevalence, Clinical Outcomes and Viral Shedding Patterns during Viral Respiratory Tract Infections in Intubated Intensive Care Unit?patients: Design and Protocol

Objective.To evaluate the effectiveness of the oral application of a 0.12% solution of Chlorhexidine for prevention of respiratory tract infections among intensive care unit (ICU) patients.Design.The study design was a double-blind, randomized, placebo-controlled trial.Setting.The study was performed in an ICU in a tertiary care hospital at a public university.Patients.Study participants comprised 194 patients admitted to the ICU with a prospective length of stay greater than 48 hours, randomized into 2 groups: those who received Chlorhexidine (n = 98) and those who received a placebo (n = 96).Intervention.Oral rinses with Chlorhexidine or a placebo were performed 3 times a day throughout the duration of the patient's stay in the ICU. Clinical data were collected prospectively.Results.Both groups displayed similar baseline clinical features. The overall incidence of respiratory tract infections (RR, 1.0 [95% confidence interval [CI], 0.63-1.60]) and the rates of ventilator-associated pneumonia per 1,000 ventilator-days were similar in both experimental and control groups (22.6 vs 22.3; P = .95). Respiratory tract infection-free survival time (7.8 vs 6.9 days; P = .61), duration of mechanical ventilation (11.1 vs 11.0 days; P = .61), and length of stay (9.7 vs 10.4 days; P = .67) did not differ between the Chlorhexidine and placebo groups. However, patients in the Chlorhexidine group exhibited a larger interval between ICU admission and onset of the first respiratory tract infection (11.3 vs 7.6 days; P = .05). The chances of surviving the ICU stay were similar (RR, 1.08 [95% CI, 0.72-1.63]).Conclusion.Oral application of a 0.12% solution of Chlorhexidine does not prevent respiratory tract infections among ICU patients, although it may retard their onset.

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Treatment of respiratory tract infections with pefloxacin in critically ill patients hospitalized in a surgical intensive care unit

Pharmaceutisch Weekblad ◽

10.1007/bf02075262 ◽

1987 ◽

Vol 9 (S1) ◽

pp. S58-S59

Author(s):

D. M. Boland ◽

W. C. F. van Gestel ◽

D. M. MacLaren ◽

D. de Jong

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Tract ◽

Critically Ill ◽

Critically Ill Patients ◽

Respiratory Tract Infections ◽

Surgical Intensive Care Unit ◽

Surgical Intensive Care ◽

Tract Infections

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Hyperimmune globulins in prevention and treatment of respiratory syncytial virus infections.

Clinical Microbiology Reviews ◽

10.1128/cmr.8.1.22 ◽

1995 ◽

Vol 8 (1) ◽

pp. 22-33 ◽

Cited By ~ 62

Author(s):

V G Hemming ◽

G A Prince ◽

J R Groothuis ◽

G R Siber

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Syncytial Virus ◽

High Risk ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Lower Respiratory Tract Infections ◽

Syncytial Virus ◽

Tract Infections

Respiratory syncytial virus (RSV) is an important community and nosocomial respiratory pathogen for infants and young children. RSV causes especially severe disease in the prematurely born or those with chronic cardiopulmonary diseases. Elderly persons and those with T-cell deficiencies, such as bone marrow transplant recipients, are also at high risk for serious lower respiratory tract infections. To date, prevention of RSV infections by vaccination has proven elusive and no preventive drugs exist. Studies in animals and humans have shown that the lower respiratory tract can be protected from RSV infection by sufficient circulating RSV neutralizing antibody levels. Recently, an RSV hyperimmune immune globulin (RSVIG) was developed and tested for the prevention of RSV infections or reduction of disease severity. Passive immunization of high-risk children with RSVIG during the respiratory disease season effected significant reductions in RSV infections, hospitalizations, days of hospitalization, intensive care unit admissions, days in the intensive care unit, and ribavirin use. Studies in cotton rats and owl monkeys show that RSV infections can also be treated with inhalation of immune globulin at doses substantially smaller than required for parenteral treatment. Therapeutic trials of parenteral RSVIG have been completed and are pending analysis. The use of polyclonal, hyperimmune globulins and perhaps human monoclonal antibodies provides an additional approach to the prevention and perhaps the treatment of certain viral lower respiratory tract infections such as those caused by RSV.

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Lower Respiratory Tract Infections in the Intensive Care Unit: Consequences of Antibiotic Resistance for Choice of Antibiotic

Microbial Drug Resistance ◽

10.1089/mdr.1995.1.163 ◽

1995 ◽

Vol 1 (2) ◽

pp. 163-167 ◽

Cited By ~ 7

Author(s):

HARTMUT LODE ◽

T. SCHABERG ◽

M. RAFFENBERG ◽

H. MAUCH

Keyword(s):

Intensive Care Unit ◽

Antibiotic Resistance ◽

Intensive Care ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Lower Respiratory Tract Infections ◽

Tract Infections

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Assessment of the intensity of the epidemic process of ventilator-associated respiratory tract infections in patients of surgical intensive care unit

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.17816/eid40868 ◽

2015 ◽

Vol 20 (2) ◽

pp. 37-42

Author(s):

O. A Orlova ◽

V. G Akimkin

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Tract ◽

Nosocomial Infections ◽

Respiratory Tract Infections ◽

Abdominal Cavity ◽

Surgical Intensive Care Unit ◽

Surgical Intensive Care ◽

Epidemic Process ◽

Tract Infections

The urgency of the problem of ventilator-associated respiratory tract infections is stipulated by the ever-increasing number of diseases caused by nosocomial polyantibiotic-resistant strains and high mortality rate. Purpose - to give an assessment of the intensity of the epidemic process of ventilator-associated respiratory tract infections in patients of the surgical intensive care unit. In the base of the analysis there were put the results of a comprehensive epidemiological, clinical, and instrumental study of 137 patients (100 patients with severe injuries and 37 patients with diseases of the abdomen and thorax) with ventilator - associated respiratory tract infections received medical treatment in the surgical intensive care unit. The proportion of respiratory tract infections in the structure of nosocomial infections in these patients varies from 34.6 to 58.9 %, in that there was revealed the prevalence of nosocomial pneumonias (63.5 %). When using a ventilator with viral-bacterial filters signs of nosocomial respiratory tract infections were manifested on the 10th day and later in 50.8 % of patients. In cases with the duration of artificial ventilation more than 10 days the risk of the development of these infections in patients with diseases of the abdominal cavity and thorax was 2.1 times higher than in patients with injuries. There was shown the necessity of the development of a set of measures for the prevention of nosocomial infections of the respiratory tract.

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