蓝鱼o_0 发表于 2014-10-9 10:36

[重磅炸弹]JAMA 2014 ESICM文章免费拿啦！

在下一期的JAMA，将会发表在巴塞罗那的ESICM会议文章，很多关注危重症和感控相关的战友去免费下载吧。

September 29 - October 1, 2014
European Society of Intensive Care Medicine 2014
These articles are published online first to coincide with presentation at the 27th ESICM Congress in Barcelona.
Selective Decontamination and Antibiotic ResistanceEditorial: Rational Use of Antibiotics in the ICUVitamin D3 in Critically Ill Patients With DeficiencyFenoldopam for AKI After Cardiac SurgeryImmune-Modulating vs Standard Enteral NutritionEditorial: Immunonutrition in Critical Illness
全文地址：http://jama.jamanetwork.com/journal.aspx
可以看到这期会议关注了抗生素的使用问题。如SDD，SOD究竟会不会引起耐药。在一篇WELL DESIGN的RCT中，会得到进一步解读。

蓝鱼o_0 发表于 2014-10-9 10:43

一、SDD，SOD是否会引起抗菌药物耐药呢？能不能影响患者死亡率改变？

JAMA的最新一期RCT研究给出了证据。文章我已经上传附件了。
可以看到Unit-wide application of SDD and SOD was associated with low levels of antibiotic resistance and no differences in day-28 mortality. Compared with SOD, SDD was associated with lower rectal carriage of antibiotic-resistant gram-negative bacteria and ICU-acquired bacteremia but a more pronounced gradual increase in aminoglycosideresistant gram-negative bacteria.

如果大家有印象相比看过之前LANCET的一片文章，
http://www.ncbi.nlm.nih.gov/pubmed/23352693
Lancet Infect Dis. 2013 Apr;13(4):328-41. doi: 10.1016/S1473-3099(12)70322-5. Epub 2013 Jan 25.
Effect of selective decontamination on antimicrobial resistance in intensive care units: a systematic review andmeta-analysis.
We detected no relation between the use of SDD or SOD and the development of antimicrobial-resistance in pathogens in patients in the ICU, suggesting that the perceived risk of long-term harm related to selective decontamination cannot be justified by available data. However, our study indicates that the effect of decontamination on ICU-level antimicrobial resistance rates is understudied. We recommend that future research includes a non-crossover, cluster randomised controlled trial to assess long-term ICU-level changes in resistance rates.当时说SDD或者SOD对于AR没有明显的效应。但是需要进一步WELL DESIGNED RCT证实。现在这也是进一步的evidence了。

蓝鱼o_0 发表于 2014-10-9 10:44

二、Rational Use of Antibiotics in the ICU Balancing Stewardship and Clinical Outcomes

这是一片EDITORIAL

阿丹丹 发表于 2014-10-9 11:45

谢谢老师分享的及时资讯{:1_1:}

田田~ 发表于 2014-10-9 13:48

赞！高质量的文献是最好的老师，学习文献中的精华，以循证医学引领感控的方向，才是中国感控人应该一直追求的目标

一叶兰123456 发表于 2014-10-9 14:58

英文困难，只有羡慕嫉妒恨的份儿。

红叶满山 发表于 2014-10-10 16:51

为了了解老师分享的文章，下一步学习英语
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