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Clinical use of selective decontamination: The concept

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Abstract

Infections can be classified according to: (1) the type of offending microorganism (virus, bacteria, fungi, parasites), (2) according to the clearance by the defence system (T cell dependent/independent) and (3) in case bacteria are the causative agents in Gram-positive and Gram-negative infections. The latter classification in Gram-positive and Gram-negative infections has appeared to have a practical consequence. Gram-negative bacteria, often involved in major infections and yeasts, appear to play practically no role in the intestinal ecological system. Consequently, it is nowadays increasingly attempted to eliminate Gram-negative bacteria and yeasts selectively from the digestive tract with antimicrobial agents. Selective suppression of Gram-positive bacteria may severely affect the ecosystem of the digestive tract. This selective suppression of Gram-negatives must be continued as long as patients are immunocompromised (locally or systemically) and is called selective decontamination of the digestive tract.

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Authors and Affiliations

  1. Laboratory for Medical Microbiology, University of Groningen, Oostersingel 59, NL-9713 EZ, Groningen, The Netherlands

    D. van der Waaij, W. L. Manson, J. P. Arends & H. G. de Vries-Hospers

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  1. D. van der Waaij
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  2. W. L. Manson
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  3. J. P. Arends
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  4. H. G. de Vries-Hospers
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van der Waaij, D., Manson, W.L., Arends, J.P. et al. Clinical use of selective decontamination: The concept. Intensive Care Med 16 (Suppl 3), S212–S216 (1990). https://doi.org/10.1007/BF01709703

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