Résumé :
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[BDSP. Notice produite par INIST gi0JR0xW. Diffusion soumise à autorisation]. Objective : To assess the effectiveness of selective digestive decontamination (SDD) on the control of nosocomial infection (NI) in critically ill pediatric patients. Design : A prospective, randomized. non-blinded and controlled clinical microbiology study. Setting : The pediatric intensive care unit (PICU) of a tertiary level pediatric university hospital. Criteria for inclusion. Patients 1 month to 14 years old. who underwent some kind of manipulation or instrumentation (mechanical ventilation, vascular cannulation, monitoring of intracranial pressure, thoracic or abdominal drainage, bladder catheterization, peritoneal dialysis, etc.) and/or presented a neurological coma requiring a stay in the PICU of 3 or more days. Patients : Over a period of 2 years. 244 patients met the inclusion criteria ; 18 patients were withdrawn because of protocol violation. The treatment group comprised 116 patients and the control group, 110 patients. Intervention : The treatment group received a triple therapy of colimycin. tobramycin and nystatin administered orally or via nasogastric tube every 6 hours. All patients with mechanical ventilation or immune-depression received decontamination treatment of the oropharyngeal cavity with hexitidine (Oraldine 0.5 mg/ml) every 6-8 hours in accordance with the PI-CU's conventional protocol. Method : Up to 10 types of nosocomial infection were diagnosed following criteria of the Centers for Disease Control (CDC). (...)
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