Multiple-site decontamination regimen decreases acquired infection incidence in mechanically ventilated COVID-19 patients

• DOI: 10.1186/s13613-022-01057-x
• Publication Date: 2022-09-02T09:03:40Z
• Authors: Nicolas Massart; Florian Reizine; Pierre Fillatre; Philippe Seguin; Béatrice La Combe; Aurélien Frerou; Pierre-Yves Egreteau; Baptiste Hourmant; Pierre Kergoat; Julien Lorber; Jerome Souchard; Emmanuel Canet; Guillaume Rieul; Yannick Fedun; Agathe Delbove; Christophe Camus
• Keywords: 2019-20 coronavirus outbreak; Regimen; Human decontamination

Among strategies that aimed to prevent acquired infections (AIs), selective decontamination regimens have been poorly studied in the COVID-19 setting. We assessed impact of a multiple-site (MSD) regimen on incidence bloodstream (BSI) and ventilator-associated pneumonia (VAP) patients receiving mechanical ventilation.We performed an ancillary analysis multicenter retrospective observational study 15 ICUs western France. In addition standard-care (SC), 3 used MSD, variant digestive decontamination, which consists administration topical antibiotics four times daily oropharynx gastric tube, chlorhexidine body wash 5-day nasal mupirocin course. AIs were compared between using MSD (MSD group) 12 SC.During period, 614 1158 admitted our ICU intubated for at least 48 h. Due missing data 153 patients, 461 finally included whom 89 received MSD. There 34 group (2117 patient-days), as with 274 SC (8957 patient-days) (p < 0.001). was independently associated lower risk AI (IRR = 0.56 [0.38-0.83]; p 0.004) (Table 2). When same model each site infection, remained VAP 0.52 [0.33-0.89]; 0.005) but not BSI 0.58, [0.25-1.34], 0.21). Hospital mortality (16.9% vs 30.1%, 0.017).In ventilated incidence.