Selective Decontamination of the Digestive Tract (SDD): Current Guidelines

Part I. The basics
Introduction
Microorganisms
Defense
Infections
Infection control
Enteral and parenteral antimicrobials used in the SDD-policy
Part II. Clinical microbiology for the ICU team
Clinical microbiology: an overview
Surveillance versus diagnostic cultures
Sampling and microscopy
Inoculation and culturing
Naming of microorganisms
Antibiotic sensitivity testing
Availability of the clinical microbiological results for the intensivist
Part III. Therapeutics
Therapy of bacterial and fungal infections
Viral infections in the ICU
Inflammation and hyperinflammation
Part IV. Surveillance
Resistance
Outbreaks
Appendix
Appendix 1. General principles before implementing the SDD-strategy
Appendix 2. Selective decontamination of the digestive tract
Appendix 3. SDD in Methicillin-resistant S. aureus (MRSA)
Appendix 4. SDD in Multidrug-resistant Gram-negative bacteria (MDRGNB).

Hans Rommes studied medicine at Utrecht University in the Netherlands. He was the Director of the Respiratory Intensive Care Unit at the University Hospital Groningen, and the Director of the Intensive Care Unit at Gelre Ziekenhuizen Apeldoorn. He has also served as a lecturer at the Antonius Hospital Nieuwegein and at the Amsterdam University Hospital, and as a member of the editorial boards of various publications. He has authored over 70 papers in international journals and books.

Rick van Saene studied medicine at the University of Leuven (Belgium), and was awarded a M.D. in 1973.  He trained and qualified as a medical microbiologist at the University of Groningen (The Netherlands) in 1977.  His research into the role of Escherichia coli in inflammatory bowel disease led to a Ph.D. in 1982 and in the same year, together with colleagues, he initiated a major clinical project entitled ‘Infection prevention in the severely traumatized patient’.  In 1987 he was appointed as a senior lecturer in Medical Microbiology at the University of Liverpool (U.K.) and consultant microbiologist at the Royal Liverpool Children’s NHS Trust (Alder Hey Hospital). He has been awarded various European research prizes, fellowship of the Royal College of Pathologists, and received merit awards for his infection prevention work using SDD. He is the author and/or co-author of more than 300 publications and books on infection control and SDD.

Miguel A. de la Cal, was Deputy Director of the Critical Care Medicine Department at the Red Cross Hospital (Madrid), General Director of Public Health, Spanish Ministry of Health,and Director of the Critical Care Medicine Department Hospital Universitario de Getafe (Madrid). He is the former Editor-in-Chief of Medicina Intensiva – the journal of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICIUC), co-editor of the book “Infection Control in the Intensive Care Unit”, , and co-author of over 100 international publications.

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