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Stress Ulcer Prophylaxis and Ventilation Pneumonia Prevention by Antibacterial Cytoprotective Agents?

Published online by Cambridge University Press:  07 April 2017

F. Daschner*
Affiliation:
Department of Hospital Epidemiology, University Hospital of Freiburg, Federal Republic of Germany
I. Kappstein
Affiliation:
Department of Hospital Epidemiology, University Hospital of Freiburg, Federal Republic of Germany
I. Engels
Affiliation:
Department of Hospital Epidemiology, University Hospital of Freiburg, Federal Republic of Germany
K. Reuschenbach
Affiliation:
Department of Hospital Epidemiology, University Hospital of Freiburg, Federal Republic of Germany
J. Pfisterer
Affiliation:
Department of Hospital Epidemiology, University Hospital of Freiburg, Federal Republic of Germany
N. Krieg
Affiliation:
Department of Anesthesiology, University Hospital of Freiburg, Federal Republic of Germany
W. Vogel
Affiliation:
Department of Anesthesiology, University Hospital of Freiburg, Federal Republic of Germany
*
Department of Hospital Epidemiology, University Hospital of Freiburg, Hugstetter Str. 55, 7800 Freiburg, FRG

Abstract

The gastric and tracheal flora of 142 consecutive patients receiving stress ulcer prophylaxis were investigated, identifying identical isolates by typing. Furthermore, the growth pattern of normal respiratory bacteria and organisms causing ventilation pneumonia at different pH values and the in vitro effect of sucralfate and bismuth subsalicylate on these bacteria in simulated gastric fluid were studied. The results obtained were as follows: (1) with rising gastric pH bacterial counts in gastric aspirates, especially gram-negatives, increased significantly; (2) in 45 (31.7%) of the patients identical organisms were first isolated in gastric samples and one to two days later in tracheal secretions; (3) ventilation pneumonia was significantly more frequent in patients with high gastric pH; (4) pathogens causing ventilation pneumonia grew well in simulated gastric fluid at higher pH values, unlike normal respiratory organisms; and (5) sucralfate and bismuth subsalicylate showed antibacterial activity against frequent causative organisms of ventilation pneumonia.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1988

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