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  • 1
    Electronic Resource
    Electronic Resource
    Nosocomial pneumonia: Epidemiology and infection control (1992)
    Springer
    Intensive care medicine 18 (1992), S. S3 
    Details
    ISSN: 1432-1238
    Keywords: Nosocomial pneumonia ; Mechanical ventilation ; Gastric colonization ; Aerobic Gram-negative bacilli ; Respiratory therapy equipment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Elderly, debilitated, or critically ill patients are at high risk for hospital acquired or nosocomial respiratory tract infection. Gram-negative bacilli,Staphylococcus aureus, and anaerobes colonizing the oropharynx are the most frequent etiologic agents. Colonization of the oropharynx may be related to the patient's age, underlying disease, nutritional status, prior exposure to antibiotics, supine position, and gastric colonization. Nosocomial pathogens may also be acquired from the hands of hospital personnel, contaminated equipment or fluids. The absence of sensitive and specific methods for accurate diagnosis remain a concern. Despite treatment with appropriate antimicrobial therapy, there is a high mortality and morbidity. Measures for the prevention of nosocomial pneumonia should include compliance with infection control principles, appropriate use of antibiotics, proper patient position, and removal of potential sources of cross colonization.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01752970
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Principles of antibiotic treatment of gram-negative bacteremia (1980)
    Springer
    Infection 8 (1980), S. 235-241 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Patienten mit gramnegativer Bakteriämie, die zwischen 1951–1958 (173 Patienten) und 1965–1974 (612 Patienten) untersucht wurden, wurden sorgfältig auf die kritischen Determinanten des Ausgangs der Erkrankung hin analysiert. Die Schwere der Grunderkrankung war der Faktor, der den Ausgang bei beiden Serien hauptsächlich beeinflußte. Frühzeitige, angemessene Antibiotikatherapie war mit einer signifikanten Verminderung sowohl der Letalität als auch der Häufigkeit der Schockentwicklung assoziiert. Angemessene Antibiotikatherapie war auch mit einer signifikanten Verminderung der Letalität assoziiert, wenn sie nach dem Eintreten des Schocks begonnen wurde. Die meisten einzelnen anti-mikrobiellen Substanzen schienen vergleichbare Effektivität zu besitzen, vorausgesetzt, der infizierende Keim war empfindlich. Es konnte nicht gezeigt werden, daß Antibiotikakombinationen wirksamer waren als Einzelsubstanzen.
    Notes: Summary Patients with gram-negative bacteremia studied between 1951–1958 (173 patients) and 1965–1974 (612 patients) were carefully evaluated to delineate critical determinants of outcome. Severity of the host's underlying disease was the major factor influencing outcome in both series. Early appropriate antibiotic therapy was associated with significant reductions in both fatality rates and the frequency of development of shock. Appropriate antibiotic therapy was also associated with a significant reduction in fatality rates even if initiated after the onset of shock. Most individual antimicrobial agents appeared to be of comparable efficacy provided the infecting organism was susceptible. Combinations of antibiotics could not be demonstrated to be more effective than single agents.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01639044
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Introductory remarks (1992)
    Springer
    Intensive care medicine 18 (1992), S. S1 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01752969
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Nosocomial pneumonia in the intubated patient: Role of gastric colonization (1989)
    Springer
    European journal of clinical microbiology & infectious diseases 8 (1989), S. 40-50 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A high rate of nosocomial pneumonia exists among intubated patients receiving mechanical ventilation. Retrograde colonization of the oropharynx and trachea with bacteria from the stomach is not widely appreciated in the pathogenesis of pneumonia. Gastric colonization is affected by age, malnutrition, antibiotics, disease of the gastrointestinal tract, and changes in pH. The widespread use of antacids and/or histamine type 2 blockers as prophylaxis against stress bleeding in the ventilated patient may also increase gastric pH and the risk of colonization in the upper gastrointestinal tract. Migration of bacteria between the stomach, oropharynx and trachea in the intubated patient may be a dynamic system involving large numbers of bacteria. The high fatality rate of mechanically ventilated patients with pneumonia, which persists despite treatment of these patients with appropriate antimicrobial therapy, underscores the need for effective measures of prevention. Preventive measures include the appropriate use of antibiotics, proper decontamination of respiratory therapy equipment, the cautious use of drugs that alter the natural gastric acid barrier, or, possibly, the selective use of antibiotics to prevent or reduce gastric, oropharyngeal and tracheal colonization.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01964119
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    Paper (German National Licenses)
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