Abstract
The treatment of infections related to multidrug resistant bacteria is a major issue in the intensive care unit. Colonization due to endogenous or exogenous bacteria represents a first step before infection in critically ill patients, in whom immunosuppression and invasive devices are common. The occurrence of infection depends on the rela- tionship between host and bacteria, and is favored by the quantity of multidrug resistant pathogens after a modifica- tion of the gut microbiota. Strategies for the prevention of healthcare-associated infections should include the reduction of colonization pressure, by measures aiming at reducing cross-transmission of multidrug resistant bacteria, and the reduction of selection pressure by reducing antimicrobial treatment. Decolonization may be an interesting comple- mentary method for critically ill patients, and should be used as a part of a global approach including the above-cited strategies.
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