{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T17:37:39Z","timestamp":1763141859199,"version":"build-2065373602"},"reference-count":57,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>The incidence of secondary infections in critically ill coronavirus disease 2019 (COVID-19) patients is worrisome. We investigated whether selective digestive decontamination (SDD) added to infection control measures during an intensive care unit (ICU) stay modified these infection rates. Methods: A retrospective observational cohort study was carried out in four ICUs in Spain. All consecutive ventilated patients with a SARS-CoV-2 infection engaged in national infection control programs between 1 March and 10 December 2020 were investigated. Patients were grouped into two cohorts according to the site of ICU admission. Secondary relevant infections were included. Infection densities corresponding to ventilator-associated pneumonia (VAP), catheter bacteremia, secondary bacteremia, and multi-resistant germs were obtained as the number of events per 1000 days of exposure and were compared between SDD and non-SDD groups using Poisson regression. Factors that had an independent association with mortality were identified using multidimensional logistic analysis. Results: There were 108 patients in the SDD cohort and 157 in the non-SDD cohort. Patients in the SDD cohort showed significantly lower rates (p &lt; 0.001) of VAP (1.9 vs. 9.3 events per 1000 ventilation days) and MDR infections (0.57 vs. 2.28 events per 1000 ICU days) and a non-significant reduction in secondary bacteremia (0.6 vs. 1.41 events per 1000 ICU days) compared with those in the non-SDD cohort. Infections caused by MDR pathogens occurred in 5 patients in the SDD cohort and 21 patients in the non-SDD cohort (p = 0.006). Differences in mortality according to SDD were not found. Conclusion: The implementation of SDD in infection control programs significantly reduced the incidence of VAP and MDR infections in critically ill SARS-CoV-2 infected patients.<\/jats:p>","DOI":"10.3390\/antibiotics11081016","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T20:49:28Z","timestamp":1659041368000},"page":"1016","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["COVID-19 Secondary Infections in ICU Patients and Prevention Control Measures: A Preliminary Prospective Multicenter Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3927-3236","authenticated-orcid":false,"given":"Sergio","family":"Ruiz-Santana","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Hospital Universitario Dr. Negr\u00edn, University of Las Palmas de Gran Canaria, Barranco de la Ballena s\/n, E-35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda-Luisa","family":"Mora-Quintero","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Hospital Universitario de Canarias (Tenerife), Carretera de Ofra s\/n, E-38320 San Crist\u00f3bal de La Laguna, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Saavedra","sequence":"additional","affiliation":[{"name":"Department of Mathematics, University of Las Palmas de Gran Canaria, E-35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Montiel-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Hospital Universitario La Candelaria, Carretera General del Rosario 145, E-38010 Santa Cruz de Tenerife, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catalina","family":"S\u00e1nchez-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Hospital Universitario Dr. Negr\u00edn, University of Las Palmas de Gran Canaria, Barranco de la Ballena s\/n, E-35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillermo","family":"P\u00e9rez-Acosta","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Complejo Hospitalario Universitario Insular-Materno Infantil, Avenida Mar\u00edtima del Sur s\/n, E-35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar","family":"Mart\u00edn-Velasco","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Hospital Universitario La Candelaria, Carretera General del Rosario 145, E-38010 Santa Cruz de Tenerife, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Crist\u00f3bal","family":"Rodr\u00edguez-Mata","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Hospital Universitario Dr. Negr\u00edn, University of Las Palmas de Gran Canaria, Barranco de la Ballena s\/n, E-35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9-Manuel","family":"Lorenzo-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Hospital Universitario de Canarias (Tenerife), Carretera de Ofra s\/n, E-38320 San Crist\u00f3bal de La Laguna, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D\u00e1cil","family":"Parrilla-Toribio","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Hospital Universitario La Candelaria, Carretera General del Rosario 145, E-38010 Santa Cruz de Tenerife, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya","family":"Carrillo-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Complejo Hospitalario Universitario Insular-Materno Infantil, Avenida Mar\u00edtima del Sur s\/n, E-35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan-Carlos","family":"Mart\u00edn-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Complejo Hospitalario Universitario Insular-Materno Infantil, Avenida Mar\u00edtima del Sur s\/n, E-35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2451","DOI":"10.1056\/NEJMcp2009575","article-title":"Severe COVID-19","volume":"383","author":"Berlin","year":"2020","journal-title":"N. 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