Oral nystatin prophylaxis in surgicaltrauma ICU patients a randomised clinical trial 英文参考文献.docVIP
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Oral nystatin prophylaxis in surgicaltrauma ICU patients a randomised clinical trial 英文参考文献
Giglioetal.CriticalCare2012,16:R57
/content/16/2/R57
RESEARCH
OpenAccess
Oralnystatinprophylaxisinsurgical/traumaICU
patients:arandomisedclinicaltrial
MariateresaGiglio1,GiuseppinaCaggiano2,LidiaDalfino1,NicolaBrienza1,IlariaAlicino1,AureliaSgobio1,
AntonellaFavale1,CaterinaCoretti2,MariaTeresaMontagna2,FrancescoBruno1andFilomenaPuntillo1*
Abstract
Introduction:CandidaprophylaxisinICUisstillamatterofdebate.Oralchemoprophylaxishasbeenadvocatedto
reducetheincidenceofCandidacolonisationandinfection.
Methods:Weperformedarandomisedtrialstudyingasingledrug(nystatin)versuscontrolinsurgical/traumaICU
patients.Multiple-sitetestingforfungiwasperformedineachpatientonICUadmission(T0)andsubsequently
every3days(T3,T6,T9,andsoforth).Theprimaryevaluationcriterionwasthetimecourseofthecorrected
colonisationindex.
Results:Ninety-ninepatientswereenrolled.Atadmission,69patientsexhibitedCandidacolonisation:themost
frequentlycolonisedbodysiteswerethestomachandthepharynx.Themostfrequentisolatedspecieswas
Candidaalbicans.ThecorrectedcolonisationindexwassimilarinthetwogroupsatT0(P=0.36),whilea
significantstatisticaldifferencewasobservedbetweenthetreatmentandcontrolgroupsatT6(median0.14and
0.33,respectively;P=0.0016),atT9(median0.00and0.28,respectively;P=0.0001),atT12(median0.00and0.41,
respectively;P=0.0008),andatT15(median0.00and0.42,respectively;P0.0003).Thesameresultswere
obtainedinthesubgroupofpatientsalreadycolonisedatICUadmission.
Conclusion:Thistrialshowsthatnystatinprophylaxissignificantlyreducesfungalcolonisationinsurgical/trauma
ICUpatients,evenifalreadycolonised.
Trialregistration:ClinicalT:NCIntroduction
morbidity,highmortality,andthesignificantuseofaddi-
Thechallengeposedbynosocomialfungalinfectionsin tionalresources.
critically ill patients hasbecome increasingly apparent
Colonisation by Candida species is the leading risk
overthepast20years.Candidaspeciesarenowamong factor for infection, and several elements support the
theleading pathogens inICUs inboth
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