Surveillance and Diagnostic Samples

A critically ill patient needs intensive monitoring and care. The functions of lungs, kidneys and heart are continuously measured and if necessary, meticulously adjusted. Curiously enough, what is happening in the gastrointestinal tract gets far less attention. Gastric retention is measured, and the motility of the digestive tract is evaluated by determining whether the patient has produced stool. One can hardly call this intensive monitoring of an essential organ such as the gastrointestinal tract. One of the reasons our digestive tract, from lips to anus, is so important is that it contains billions of microorganisms and many grams of toxic bacterial products, i.e. endotoxins. This is where the clinical microbiologist enters the story. The clinical microbiologist is the only person in the hospital who can provide the ICU team with information about the interaction between the patient and her or his oropharyngeal and intestinal microbiological flora. For this, he only needs an oropharyngeal and rectal swab taken on admission of the patient and subsequently twice weekly. These so-called surveillance cultures enable intensivists to monitor the microbiological flora of their patients.