Short-duration selective decontamination of the digestive tract infection control does not contribute to increased antimicrobial resistance burden in a pilot cluster randomised trial (the ARCTIC Study). ...

• Main Authors: Kean, Iain Robert Louis, Clark, John A, Zhang, Zhenguang, Daubney, Esther, White, Deborah, Ferrando-Vivas, Paloma, Milla, Gema, Cuthbertson, Brian, Pappachan, John, Klein, Nigel, Mouncey, Paul, Rowan, Kathy, Myburgh, John, Gouliouris, Theodore, Baker, Stephen, Parkhill, Julian, Pathan, Nazima, Arctic Research Team
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMJ 2024
• Subjects: ANTIBIOTIC THERAPY; DRUG RESISTANCE; Arctic
• Online Access: https://dx.doi.org/10.17863/cam.105447; https://www.repository.cam.ac.uk/handle/1810/363335

OBJECTIVE: Selective decontamination of the digestive tract (SDD) is a well-studied but hotly contested medical intervention of enhanced infection control. Here, we aim to characterise the changes to the microbiome and antimicrobial resistance (AMR) gene profiles in critically ill children treated with SDD-enhanced infection control compared with conventional infection control. DESIGN: We conducted shotgun metagenomic microbiome and resistome analysis on serial oropharyngeal and faecal samples collected from critically ill, mechanically ventilated patients in a pilot multicentre cluster randomised trial of SDD. The microbiome and AMR profiles were compared for longitudinal and intergroup changes. Of consented patients, faecal microbiome baseline samples were obtained in 89 critically ill children. Additionally, samples collected during and after critical illness were collected in 17 children treated with SDD-enhanced infection control and 19 children who received standard care. RESULTS: SDD affected the ...