학술논문

Catheter-related bloodstream infections in children with intestinal failure:a 6-year review from an intestinal rehabilitation center in China
Document Type
Academic Journal
Source
世界儿科杂志(英文版) / World Journal of Pediatrics. 18(4):271-277
Subject
Enteric pathogens
Fecal examination
Gastrointestinal symptoms
Language
Chinese
ISSN
1708-8569
Abstract
Background Children with intestinal failure(IF)have frequent catheter-related bloodstream infections(CRBSIs).This study aimed to analyze the clinical presentation and laboratory parameters of CRBSIs in children with IF.Methods This 6-year retrospective study was conducted among IF children with CRBSIs at an intestinal rehabilitation center in China.Clinical data were collected,including data of temperature and gastrointestinal symptoms.Blood/catheter culture,fecal tests,and calculation of inflammatory index were performed,which were obtained within 1 week since CRBSI onset.Results Fifty children with 87 CRBSIs were identified,of which there were 17 suspected and 70 confirmed cases.Seventy-two pathogens were cultured from 70 positive blood cultures:63%were Gram-positive organisms,23%were Gram-negative organisms,and 11%were fungal organisms.Overall,48.6%were enteric organisms;47.2%of bacterial pathogens were consistent between fecal and blood cultures.Moreover,46.3%fecal routines showed abnormalities including increased white blood cells,occult blood positive and the presence of fat droplets.The consistent symptom at onset of CRBSIs was fever and gastrointestinal symptoms including increased stool output,abdominal distension,or both.C-reactive protein(CRP)and procalcitonin(PCT)were elevated,i.e.,16.5 mg/L[interquartile range(IQR)8.7-44.7]and 0.48 ng/mL(IQR 0.2-1.76),respectively.Conclusions IF children had a high rate of CRBSIs,of which larger proportions were due to Gram-positive and enteric organ-isms.Fever and/or gastrointestinal symptoms,combined with elevated CRP and PCT,is conducive to the early diagnosis of CRBSIs in IF patients.