Unusually High Incidences of Staphylococcus Aureus Infection Within Studies of Ventilator Associated Pneumonia Prevention Using Topical Antibiotics: Benchmarking the Evidence Base

Overview

Journal Microorganisms

Specialty Microbiology

Date 2018 Jan 5

PMID 29300363

Citations 8

Authors

James C Hurley

Affiliations

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Abstract

Selective digestive decontamination (SDD, topical antibiotic regimens applied to the respiratory tract) appears effective for preventing ventilator associated pneumonia (VAP) in intensive care unit (ICU) patients. However, potential contextual effects of SDD on infections in the ICU remain unclear. The ventilator associated pneumonia ( VAP), VAP overall and bacteremia incidences within component (control and intervention) groups within 27 SDD studies were benchmarked against 115 observational groups. Component groups from 66 studies of various interventions other than SDD provided additional points of reference. In 27 SDD study control groups, the mean VAP incidence is 9.6% (95% CI; 6.9-13.2) versus a benchmark derived from 115 observational groups being 4.8% (95% CI; 4.2-5.6). In nine SDD study control groups the mean bacteremia incidence is 3.8% (95% CI; 2.1-5.7) versus a benchmark derived from 10 observational groups being 2.1% (95% CI; 1.1-4.1). The incidences of VAP and bacteremia within the control groups of SDD studies are each higher than literature derived benchmarks. Paradoxically, within the SDD intervention groups, the incidences of both VAP and VAP overall are more similar to the benchmarks.

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