Infections colonization versus

Bonten Ml, Gaillard CA, van der Geest S, et al. The role of intragas-tric acidity and stress ulcus prophylaxis on colonization and infection in mechanically ventilated ICU patients A stratified, randomized, doubleblind study of sucralfate versus antacids. Am J Respir CritCare Med 1995 152 1825-1834. 

Infection risk Catheter-related bloodstream infections pose a significant problem for hospitalized patients. In a randomized comparison in 960 patients of 5-fiuoruracil or chlorhexidine-I-silver sulfadiazine as central venous catheter coatings, 5-fluorouracil was non-inferior to chlorhexidine-b silver sulfadiazine with respect to the incidence of catheter colonization (2.9% versus 5.3%) [ll ]. Local site infections occurred in 1.4% with 5-fluoruracil and 0.9% with chlorhexidine + silver sulfadiazine. There were no episodes of catheter-related bloodstream infections with 5-fluoruracil but two episodes with chlorhexidine + silver sulfadiazine. The incidence of adverse events was low and comparable in the two groups. 

Dryden, M.S., S. Dailly, and M. Crouch, 2004. A randomised, controlled trial of tea tree topical preparations versus a standard topical regimen for the clearance of MRSA colonization. J. Hospital Infect., 56 283-286. 

Epidemiological studies, as outlined previously, are difficult, and when bioassays are based on measuring spore survival, infection versus colonization rates, disease intensity, inoculum potential, or any other characteristic, careful experimental design is vital to generating meaningful results (Kranz Rotem 1988). 

Once the diagnosis of nosocomial pneumonia has been established, several important factors must be considered before a rational empirical antimicrobial regimen can be chosen. These include severity of illness and comorbid conditions of the patient, prior antibiotic use, early versus late onset of infection, results of the sputum Gram s stain, and the resident flora profile of the institution, particularly in the intensive care unit (Table 1). Empirical antimicrobial therapy for nosocomial pneumonia in a ventilated patient with renal failure in whom multiple intra-abdominal abscesses develop following colon resection is very different from the patient who aspirates following an otherwise uncomplicated cholecystectomy. 

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