Journal ArticleDOI
Infection Prevention During Profound Granulocytopenia: New Approaches to Alimentary Canal Microbial Suppression
TLDR
The concept of colonization resistance may be the new approach needed for microbial suppression of the nonisolated patient if the anaerobic flora is undisturbed and newly acquired organisms generally cannot colonize the patient.Abstract:
During the past 10 years the concepts of total reverse isolation using laminar air flow rooms and alimentary canal microbial suppression using oral nonabsorbable antibiotics have each been proved effective in reducing serious infection for patients with profound, prolonged granulocytopenia. When these two modalities are combined, the net reduction in infections is about 75%. Oral nonabsorbable antibiotics, however, are poorly tolerated, costly, and frequently associated with the acquisition of resistant gram-negative rods when used outside the laminar air flow room setting. The concept of colonization resistance may be the new approach needed for microbial suppression of the nonisolated patient. If the anaerobic flora is undisturbed, newly acquired organisms generally cannot colonize the patient. Agents such as trimethoprim/sulfamethoxazole suppress many of the potentially pathogenic aerobic bacteria but not the anaerobes, leaving colonization resistance relatively intact. The result thus far has been a reduction in infection without a concurrent increase in colonization or infection by organisms resistant to the antimicrobial agents commonly used for therapy.read more
Citations
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Journal ArticleDOI
Intestinal flora in health and disease.
TL;DR: LaMicroflore normale, les etats pathologiques associes a une microflore anormale, la relation entre le cancer du colon et la microflor intestinale, the microflores intestinales et the circulation enterohepatique des hormones steroides sexuelles.
Journal ArticleDOI
The effect of selective decontamination of the digestive tract on colonisation and infection rate in multiple trauma patients.
TL;DR: Multiple trauma patients staying in the ICU for 5 or more days and needing mechanical ventilation were investigated to determine the effect of selective decontamination of the digestive tract on prevention of infection.
Journal ArticleDOI
The Microbiology of Multiple Organ Failure: The Proximal Gastrointestinal Tract as an Occult Reservoir of Pathogens
TL;DR: The proximal gastrointestinal tract appears to be an important occult reservoir of the predominant pathogens in MOF, and Candida, S epidermidis, and Pseudomonas were found to be the most common isolates.
Journal ArticleDOI
The human intestinal microflora.
TL;DR: Current interests are focused on the bacterial flora of tropical sprue, the role of bacteria in colorectal cancer, and the involvement of intestinal microflora in the enterohepatic circulation of sex steroid hormones.
Journal ArticleDOI
Intestinal and Hepatic Complications of Human Bone Marrow Transplantation. Part II
George B. McDonald,George B. McDonald,Howard M. Shulman,Howard M. Shulman,Keith M. Sullivan,Keith M. Sullivan,Gerald D. Spencer,Gerald D. Spencer +7 more
TL;DR: The authors thank E. Donnall Thomas for his constant encouragement; Derek Jewell for his gift of time; Kathleen McDonald for her editing skills; and Barbara Hicks, Patricia Jenkins, and Maxine Cormier for their help in typing the manuscript.
References
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Journal ArticleDOI
Successful Chemoprophylaxis for Pneumocystis carinii Pneumonitis
Walter T. Hughes,Shirley Kuhn,Subhash Chaudhary,Sandor Feldman,M. S. Verzosa,Rhomes J. A. Aur,Charles B. Pratt,Stephen L. George +7 more
TL;DR: The study shows the combination to be highly effective in the prevention of P. carinii pneumonitis and oral candidiasis was the only adverse effect ecountered from trimethoprim-sulfamethoxazole administration.
Journal ArticleDOI
Origin of infection in acute nonlymphocytic leukemia. Significance of hospital acquisition of potential pathogens.
Stephen C. Schimpff,Viola Mae Young,William H. Greene,Gerald D. Vermeulen,Marcia R. Moody,Peter H. Wiernik +5 more
Journal ArticleDOI
Infection prevention in acute nonlymphocytic leukemia. Laminar air flow room reverse isolation with oral, nonabsorbable antibiotic prophylaxis.
Stephen C. Schimpff,William H. Greene,Viola Mae Young,Clarence L. Fortner,Cusack N,Jerome B. Block,Peter H. Wiernik +6 more
TL;DR: The LAF plus A and the W plus A patients had higher complete remission rates and longer median survival than the unprotected ward patients and those who could not tolerate the antibiotics had an incidence of infection comparable to the ward patients.
Journal ArticleDOI
Protected environments and prophylactic antibiotics. A prospective controlled study of their utility in the therapy of acute leukemia.
Arthur S. Levine,Stuart E. Siegel,Alan D. Schreiber,Janet Hauser,Harvey D. Preisler,Ira M. Goldstein,Florence Seidler,Richard Simon,Seymour Perry,John E. Bennett,Edward S. Henderson +10 more
TL;DR: Environmental maneuvers were effective in reducing the potential inoculum of ambient micro-organisms in acute leukemia and no intergroup differences were found in remission rat...
Journal ArticleDOI
Infection prevention in granulocytopenic patients by selective decontamination of the digestive tract
Dirk Sleijfer,Nanno Mulder,Hilly G. De Vries-Hospers,Vaclav Fidler,Hendrik O. Nieweg,Dirk van der Waaij,Hendrik K.F. van Saene +6 more
TL;DR: It is concluded that SDD is a promising and widely applicable method of infection prevention that decreases the need for treatment in a ‘protected environment’.