Gram-positive cocci in Dutch ICUs with and without selective decontamination of the oropharyngeal and digestive tract: A retrospective database analysis

A. K. Van der Bij; D. Frentz; M. J.M. Bonten; ISIS-AR study group; J. W.T. Cohen Stuart; B. C. Van Hees; J. Vijfhuizen; R. G.F. Wintermans; W. Altorf-Van der Kuil; J. Alblas; J. Van Heereveld; R. Hertroys; T. Leenstra; J. C. Monen; S. H.S. Woudt; S. C. De Greeff; P. H.J. Van Keulen; J. A.J.W. Kluytmans; E. E. Mattsson; F. W. Sebens; H. M.E. Frenay; B. Maraha; T. Halaby; D. Versteeg; R. Hendrix; J. F.P. Schellekens; B. M.W. Diederen; E. I.G.B. De Brauwer; F. S. Stals; L. J. Bakker; J. W. Dorigo-Zetsma; J. H. Van Zeijl; A. T. Bernards; B. M. De Jongh; B. J.M. Vlaminckx; A. Horrevorts; S. Kuipers; R. G.F. Wintermans; B. Moffie; R. W. Brimicombe; C. L. Jansen; N. H.M. Renders; B. G.A. Hendrickx; A. G.M. Buiting; S. F.T. Thijsen; M. P.D. Deege; F. N.J. Frakking; H. T. Tjhie; A. A. Van Zwet

doi:10.1093/jac/dkv396

Gram-positive cocci in Dutch ICUs with and without selective decontamination of the oropharyngeal and digestive tract: A retrospective database analysis

A. K. Van der Bij^*, D. Frentz, M. J.M. Bonten, ISIS-AR study group, J. W.T. Cohen Stuart, B. C. Van Hees, J. Vijfhuizen, R. G.F. Wintermans, W. Altorf-Van der Kuil, J. Alblas, J. Van Heereveld, R. Hertroys, T. Leenstra, J. C. Monen, S. H.S. Woudt, S. C. De Greeff, P. H.J. Van Keulen, J. A.J.W. Kluytmans, E. E. Mattsson, F. W. SebensH. M.E. Frenay, B. Maraha, T. Halaby, D. Versteeg, R. Hendrix, J. F.P. Schellekens, B. M.W. Diederen, E. I.G.B. De Brauwer, F. S. Stals, L. J. Bakker, J. W. Dorigo-Zetsma, J. H. Van Zeijl, A. T. Bernards, B. M. De Jongh, B. J.M. Vlaminckx, A. Horrevorts, S. Kuipers, R. G.F. Wintermans, B. Moffie, R. W. Brimicombe, C. L. Jansen, N. H.M. Renders, B. G.A. Hendrickx, A. G.M. Buiting, S. F.T. Thijsen, M. P.D. Deege, F. N.J. Frakking, H. T. Tjhie, A. A. Van Zwet

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

19 Citations (Scopus)

Abstract

Objectives: The objective of this study was to determine time trends in the rate of Gram-positive cocci in 42 Dutch ICUs that continuously used or did not use selective oropharyngeal decontamination (SOD) or selective decontamination of the digestive tract (SDD) and ICUs that introduced SOD/SDD. Methods: The Dutch Surveillance System on Antibiotic Resistance was used to determine monthly rates of Staphylococcus aureus, Enterococcus faecalis and Enterococcus faecium isolates, including resistant phenotypes, in blood and respiratory tract specimens from 2008 to 2013. Per patient, the last isolate per species per month was selected, and cumulative rates per 100 beds per month were determined. Time trends were analysed by multilevel Poisson regression. Results: Eighteen ICUs used SOD/SDD (1296 months), 13 did not use SOD/SDD (936 months) and 11 introduced SOD/SDD (373 months before and 419 months after introduction). There was no significant increase in the rate of Gram-positive cocci in ICUs that used SOD/SDD. Introduction of SOD/SDD was associated with increased rates of S. aureus (β = 0.018, 95% CI 0.006-0.030) and E. faecalis isolates (β = 0.028, 95% CI 0.006-0.051) in respiratory tract specimens. Numbers of resistant phenotypes remained low, and an observed increase in E. faecium isolates (β = 0.033, 95% CI 0.012-0.054), 97% of which were resistant to ampicillin, in the absence of SOD/SDD disappeared after the introduction of SOD/SDD. Conclusions: In ICUs with a low endemicity of resistance, introduction of SOD/SDD was associated with increased rates of S. aureus and E. faecalis isolates, but not with resistant phenotypes. Continuous 5 year use of SOD/SDD was not associated with increased isolation of Gram-positive cocci.

Original language	English
Pages (from-to)	816-820
Number of pages	5
Journal	Journal of Antimicrobial Chemotherapy
Volume	71
Issue number	3
DOIs	https://doi.org/10.1093/jac/dkv396
Publication status	Published - 1 Mar 2016
Externally published	Yes

Bibliographical note

Publisher Copyright:
© The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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_104_2015_09_SDD-SOD_ISIS-AR_Gram_pos_coccen_JACFinal published version, 145 KB

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Van der Bij, A. K., Frentz, D., Bonten, M. J. M., ISIS-AR study group, Cohen Stuart, J. W. T., Van Hees, B. C., Vijfhuizen, J., Wintermans, R. G. F., Altorf-Van der Kuil, W., Alblas, J., Van Heereveld, J., Hertroys, R., Leenstra, T., Monen, J. C., Woudt, S. H. S., De Greeff, S. C., Van Keulen, P. H. J., Kluytmans, J. A. J. W., Mattsson, E. E., ... Van Zwet, A. A. (2016). Gram-positive cocci in Dutch ICUs with and without selective decontamination of the oropharyngeal and digestive tract: A retrospective database analysis. Journal of Antimicrobial Chemotherapy, 71(3), 816-820. https://doi.org/10.1093/jac/dkv396

@article{0b4e76b3141a411ca3ed86fbc27b307f,

title = "Gram-positive cocci in Dutch ICUs with and without selective decontamination of the oropharyngeal and digestive tract: A retrospective database analysis",

abstract = "Objectives: The objective of this study was to determine time trends in the rate of Gram-positive cocci in 42 Dutch ICUs that continuously used or did not use selective oropharyngeal decontamination (SOD) or selective decontamination of the digestive tract (SDD) and ICUs that introduced SOD/SDD. Methods: The Dutch Surveillance System on Antibiotic Resistance was used to determine monthly rates of Staphylococcus aureus, Enterococcus faecalis and Enterococcus faecium isolates, including resistant phenotypes, in blood and respiratory tract specimens from 2008 to 2013. Per patient, the last isolate per species per month was selected, and cumulative rates per 100 beds per month were determined. Time trends were analysed by multilevel Poisson regression. Results: Eighteen ICUs used SOD/SDD (1296 months), 13 did not use SOD/SDD (936 months) and 11 introduced SOD/SDD (373 months before and 419 months after introduction). There was no significant increase in the rate of Gram-positive cocci in ICUs that used SOD/SDD. Introduction of SOD/SDD was associated with increased rates of S. aureus (β = 0.018, 95% CI 0.006-0.030) and E. faecalis isolates (β = 0.028, 95% CI 0.006-0.051) in respiratory tract specimens. Numbers of resistant phenotypes remained low, and an observed increase in E. faecium isolates (β = 0.033, 95% CI 0.012-0.054), 97% of which were resistant to ampicillin, in the absence of SOD/SDD disappeared after the introduction of SOD/SDD. Conclusions: In ICUs with a low endemicity of resistance, introduction of SOD/SDD was associated with increased rates of S. aureus and E. faecalis isolates, but not with resistant phenotypes. Continuous 5 year use of SOD/SDD was not associated with increased isolation of Gram-positive cocci.",

author = "{Van der Bij}, {A. K.} and D. Frentz and Bonten, {M. J.M.} and {ISIS-AR study group} and {Cohen Stuart}, {J. W.T.} and {Van Hees}, {B. C.} and J. Vijfhuizen and Wintermans, {R. G.F.} and {Altorf-Van der Kuil}, W. and J. Alblas and {Van Heereveld}, J. and R. Hertroys and T. Leenstra and Monen, {J. C.} and Woudt, {S. H.S.} and {De Greeff}, {S. C.} and {Van Keulen}, {P. H.J.} and Kluytmans, {J. A.J.W.} and Mattsson, {E. E.} and Sebens, {F. W.} and Frenay, {H. M.E.} and B. Maraha and T. Halaby and D. Versteeg and R. Hendrix and Schellekens, {J. F.P.} and Diederen, {B. M.W.} and {De Brauwer}, {E. I.G.B.} and Stals, {F. S.} and Bakker, {L. J.} and Dorigo-Zetsma, {J. W.} and {Van Zeijl}, {J. H.} and Bernards, {A. T.} and {De Jongh}, {B. M.} and Vlaminckx, {B. J.M.} and A. Horrevorts and S. Kuipers and Wintermans, {R. G.F.} and B. Moffie and Brimicombe, {R. W.} and Jansen, {C. L.} and Renders, {N. H.M.} and Hendrickx, {B. G.A.} and Buiting, {A. G.M.} and Thijsen, {S. F.T.} and Deege, {M. P.D.} and Frakking, {F. N.J.} and Tjhie, {H. T.} and {Van Zwet}, {A. A.}",

note = "Publisher Copyright: {\textcopyright} The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. ",

year = "2016",

month = mar,

day = "1",

doi = "10.1093/jac/dkv396",

language = "English",

volume = "71",

pages = "816--820",

journal = "Journal of Antimicrobial Chemotherapy",

issn = "0305-7453",

publisher = "Oxford University Press",

number = "3",

}

Van der Bij, AK, Frentz, D, Bonten, MJM, ISIS-AR study group, Cohen Stuart, JWT, Van Hees, BC, Vijfhuizen, J, Wintermans, RGF, Altorf-Van der Kuil, W, Alblas, J, Van Heereveld, J, Hertroys, R, Leenstra, T, Monen, JC, Woudt, SHS, De Greeff, SC, Van Keulen, PHJ, Kluytmans, JAJW, Mattsson, EE, Sebens, FW, Frenay, HME, Maraha, B, Halaby, T, Versteeg, D, Hendrix, R, Schellekens, JFP, Diederen, BMW, De Brauwer, EIGB, Stals, FS, Bakker, LJ, Dorigo-Zetsma, JW, Van Zeijl, JH, Bernards, AT, De Jongh, BM, Vlaminckx, BJM, Horrevorts, A, Kuipers, S, Wintermans, RGF, Moffie, B, Brimicombe, RW, Jansen, CL, Renders, NHM, Hendrickx, BGA, Buiting, AGM, Thijsen, SFT, Deege, MPD, Frakking, FNJ, Tjhie, HT & Van Zwet, AA 2016, 'Gram-positive cocci in Dutch ICUs with and without selective decontamination of the oropharyngeal and digestive tract: A retrospective database analysis', Journal of Antimicrobial Chemotherapy, vol. 71, no. 3, pp. 816-820. https://doi.org/10.1093/jac/dkv396

Gram-positive cocci in Dutch ICUs with and without selective decontamination of the oropharyngeal and digestive tract: A retrospective database analysis. / Van der Bij, A. K.; Frentz, D.; Bonten, M. J.M. et al.
In: Journal of Antimicrobial Chemotherapy, Vol. 71, No. 3, 01.03.2016, p. 816-820.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Gram-positive cocci in Dutch ICUs with and without selective decontamination of the oropharyngeal and digestive tract

T2 - A retrospective database analysis

AU - Van der Bij, A. K.

AU - Frentz, D.

AU - Bonten, M. J.M.

AU - ISIS-AR study group

AU - Cohen Stuart, J. W.T.

AU - Van Hees, B. C.

AU - Vijfhuizen, J.

AU - Wintermans, R. G.F.

AU - Altorf-Van der Kuil, W.

AU - Alblas, J.

AU - Van Heereveld, J.

AU - Hertroys, R.

AU - Leenstra, T.

AU - Monen, J. C.

AU - Woudt, S. H.S.

AU - De Greeff, S. C.

AU - Van Keulen, P. H.J.

AU - Kluytmans, J. A.J.W.

AU - Mattsson, E. E.

AU - Sebens, F. W.

AU - Frenay, H. M.E.

AU - Maraha, B.

AU - Halaby, T.

AU - Versteeg, D.

AU - Hendrix, R.

AU - Schellekens, J. F.P.

AU - Diederen, B. M.W.

AU - De Brauwer, E. I.G.B.

AU - Stals, F. S.

AU - Bakker, L. J.

AU - Dorigo-Zetsma, J. W.

AU - Van Zeijl, J. H.

AU - Bernards, A. T.

AU - De Jongh, B. M.

AU - Vlaminckx, B. J.M.

AU - Horrevorts, A.

AU - Kuipers, S.

AU - Wintermans, R. G.F.

AU - Moffie, B.

AU - Brimicombe, R. W.

AU - Jansen, C. L.

AU - Renders, N. H.M.

AU - Hendrickx, B. G.A.

AU - Buiting, A. G.M.

AU - Thijsen, S. F.T.

AU - Deege, M. P.D.

AU - Frakking, F. N.J.

AU - Tjhie, H. T.

AU - Van Zwet, A. A.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Objectives: The objective of this study was to determine time trends in the rate of Gram-positive cocci in 42 Dutch ICUs that continuously used or did not use selective oropharyngeal decontamination (SOD) or selective decontamination of the digestive tract (SDD) and ICUs that introduced SOD/SDD. Methods: The Dutch Surveillance System on Antibiotic Resistance was used to determine monthly rates of Staphylococcus aureus, Enterococcus faecalis and Enterococcus faecium isolates, including resistant phenotypes, in blood and respiratory tract specimens from 2008 to 2013. Per patient, the last isolate per species per month was selected, and cumulative rates per 100 beds per month were determined. Time trends were analysed by multilevel Poisson regression. Results: Eighteen ICUs used SOD/SDD (1296 months), 13 did not use SOD/SDD (936 months) and 11 introduced SOD/SDD (373 months before and 419 months after introduction). There was no significant increase in the rate of Gram-positive cocci in ICUs that used SOD/SDD. Introduction of SOD/SDD was associated with increased rates of S. aureus (β = 0.018, 95% CI 0.006-0.030) and E. faecalis isolates (β = 0.028, 95% CI 0.006-0.051) in respiratory tract specimens. Numbers of resistant phenotypes remained low, and an observed increase in E. faecium isolates (β = 0.033, 95% CI 0.012-0.054), 97% of which were resistant to ampicillin, in the absence of SOD/SDD disappeared after the introduction of SOD/SDD. Conclusions: In ICUs with a low endemicity of resistance, introduction of SOD/SDD was associated with increased rates of S. aureus and E. faecalis isolates, but not with resistant phenotypes. Continuous 5 year use of SOD/SDD was not associated with increased isolation of Gram-positive cocci.

AB - Objectives: The objective of this study was to determine time trends in the rate of Gram-positive cocci in 42 Dutch ICUs that continuously used or did not use selective oropharyngeal decontamination (SOD) or selective decontamination of the digestive tract (SDD) and ICUs that introduced SOD/SDD. Methods: The Dutch Surveillance System on Antibiotic Resistance was used to determine monthly rates of Staphylococcus aureus, Enterococcus faecalis and Enterococcus faecium isolates, including resistant phenotypes, in blood and respiratory tract specimens from 2008 to 2013. Per patient, the last isolate per species per month was selected, and cumulative rates per 100 beds per month were determined. Time trends were analysed by multilevel Poisson regression. Results: Eighteen ICUs used SOD/SDD (1296 months), 13 did not use SOD/SDD (936 months) and 11 introduced SOD/SDD (373 months before and 419 months after introduction). There was no significant increase in the rate of Gram-positive cocci in ICUs that used SOD/SDD. Introduction of SOD/SDD was associated with increased rates of S. aureus (β = 0.018, 95% CI 0.006-0.030) and E. faecalis isolates (β = 0.028, 95% CI 0.006-0.051) in respiratory tract specimens. Numbers of resistant phenotypes remained low, and an observed increase in E. faecium isolates (β = 0.033, 95% CI 0.012-0.054), 97% of which were resistant to ampicillin, in the absence of SOD/SDD disappeared after the introduction of SOD/SDD. Conclusions: In ICUs with a low endemicity of resistance, introduction of SOD/SDD was associated with increased rates of S. aureus and E. faecalis isolates, but not with resistant phenotypes. Continuous 5 year use of SOD/SDD was not associated with increased isolation of Gram-positive cocci.

UR - http://www.scopus.com/inward/record.url?scp=84960839625&partnerID=8YFLogxK

U2 - 10.1093/jac/dkv396

DO - 10.1093/jac/dkv396

M3 - Article

C2 - 26661393

AN - SCOPUS:84960839625

SN - 0305-7453

VL - 71

SP - 816

EP - 820

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

IS - 3

ER -

Gram-positive cocci in Dutch ICUs with and without selective decontamination of the oropharyngeal and digestive tract: A retrospective database analysis

Abstract

Bibliographical note

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