Enteral Vancomycin to Eliminate MRSA Carriership of the Digestive Tract in Critically Ill Patients
Background: Carriership with methicillin resistant <i>Staphylococcus aureus</i> (MRSA) is a risk for the development of secondary infections in critically ill patients. Previous studies suggest that enteral vancomycin is able to eliminate enteral carriership with MRSA. Data on individual...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/2/263 |
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| author | Sophie H. Buitinck Matty Koopmans Rogier M. Determann Rogier R. Jansen Peter H. J. van der Voort |
| author_facet | Sophie H. Buitinck Matty Koopmans Rogier M. Determann Rogier R. Jansen Peter H. J. van der Voort |
| author_sort | Sophie H. Buitinck |
| collection | DOAJ |
| description | Background: Carriership with methicillin resistant <i>Staphylococcus aureus</i> (MRSA) is a risk for the development of secondary infections in critically ill patients. Previous studies suggest that enteral vancomycin is able to eliminate enteral carriership with MRSA. Data on individual effects of this treatment are lacking. Methods: Retrospective analysis of a database containing 15 year data of consecutive patients from a mixed medical-(cardio)surgical 18 bedded intensive care unit was conducted. All consecutive critically ill patients with enteral MRSA carriership detected in throat and/or rectal samples were collected. We analyzed those with follow-up cultures to determine the success rate of enteral vancomycin. Topical application of 2% vancomycin in a sticky oral paste was performed combined with a vancomycin solution of 500 mg four times daily in the nasogastric tube. This treatment was added to a regimen of selective digestive tract decontamination (SDD) to prevent ICU acquired infection. Results: Thirteen patients were included. The mean age was 65 years and the median APACHE II score was 21. MRSA was present in the throat in 8 patients and in both throat and rectum in 5 patients. In all patients MRSA was successfully eliminated from both throat and rectum, which took 2–11 days with a median duration until decontamination of 4 days. Secondary infections with MRSA did not occur. Conclusions: Topical treatment with vancomycin in a 2% sticky oral paste four times daily in the nasogastric tube was effective in all patients in the elimination of MRSA and prevented secondary MRSA infections. |
| first_indexed | 2024-03-09T22:46:57Z |
| format | Article |
| id | doaj.art-ec8527e5d5714cce805c52ee66c2e397 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T22:46:57Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-ec8527e5d5714cce805c52ee66c2e3972023-11-23T18:29:14ZengMDPI AGAntibiotics2079-63822022-02-0111226310.3390/antibiotics11020263Enteral Vancomycin to Eliminate MRSA Carriership of the Digestive Tract in Critically Ill PatientsSophie H. Buitinck0Matty Koopmans1Rogier M. Determann2Rogier R. Jansen3Peter H. J. van der Voort4Department of Intensive Care, OLVG Hospital, P.O. Box 95500, 1090 HM Amsterdam, The NetherlandsDepartment of Intensive Care, OLVG Hospital, P.O. Box 95500, 1090 HM Amsterdam, The NetherlandsDepartment of Intensive Care, OLVG Hospital, P.O. Box 95500, 1090 HM Amsterdam, The NetherlandsDepartment of Medical Microbiology, OLVG Hospital, Oosterpark 9, 1091 AC Amsterdam, The NetherlandsDepartment of Critical Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The NetherlandsBackground: Carriership with methicillin resistant <i>Staphylococcus aureus</i> (MRSA) is a risk for the development of secondary infections in critically ill patients. Previous studies suggest that enteral vancomycin is able to eliminate enteral carriership with MRSA. Data on individual effects of this treatment are lacking. Methods: Retrospective analysis of a database containing 15 year data of consecutive patients from a mixed medical-(cardio)surgical 18 bedded intensive care unit was conducted. All consecutive critically ill patients with enteral MRSA carriership detected in throat and/or rectal samples were collected. We analyzed those with follow-up cultures to determine the success rate of enteral vancomycin. Topical application of 2% vancomycin in a sticky oral paste was performed combined with a vancomycin solution of 500 mg four times daily in the nasogastric tube. This treatment was added to a regimen of selective digestive tract decontamination (SDD) to prevent ICU acquired infection. Results: Thirteen patients were included. The mean age was 65 years and the median APACHE II score was 21. MRSA was present in the throat in 8 patients and in both throat and rectum in 5 patients. In all patients MRSA was successfully eliminated from both throat and rectum, which took 2–11 days with a median duration until decontamination of 4 days. Secondary infections with MRSA did not occur. Conclusions: Topical treatment with vancomycin in a 2% sticky oral paste four times daily in the nasogastric tube was effective in all patients in the elimination of MRSA and prevented secondary MRSA infections.https://www.mdpi.com/2079-6382/11/2/263vancomycinoralMRSAcarriershipcolonizationSDD |
| spellingShingle | Sophie H. Buitinck Matty Koopmans Rogier M. Determann Rogier R. Jansen Peter H. J. van der Voort Enteral Vancomycin to Eliminate MRSA Carriership of the Digestive Tract in Critically Ill Patients Antibiotics vancomycin oral MRSA carriership colonization SDD |
| title | Enteral Vancomycin to Eliminate MRSA Carriership of the Digestive Tract in Critically Ill Patients |
| title_full | Enteral Vancomycin to Eliminate MRSA Carriership of the Digestive Tract in Critically Ill Patients |
| title_fullStr | Enteral Vancomycin to Eliminate MRSA Carriership of the Digestive Tract in Critically Ill Patients |
| title_full_unstemmed | Enteral Vancomycin to Eliminate MRSA Carriership of the Digestive Tract in Critically Ill Patients |
| title_short | Enteral Vancomycin to Eliminate MRSA Carriership of the Digestive Tract in Critically Ill Patients |
| title_sort | enteral vancomycin to eliminate mrsa carriership of the digestive tract in critically ill patients |
| topic | vancomycin oral MRSA carriership colonization SDD |
| url | https://www.mdpi.com/2079-6382/11/2/263 |
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