Wataru Sumida1, Yoshio Watanabe, Hidemi Takasu, Kazuo Oshima. 1. Department of Pediatric Surgery, Aichi Children's Health and Medical Center, 1-2 Osakada, Morioka-cho, 474-8710, Obu, Aichi, Japan, wsumida288gto@yahoo.co.jp.
Abstract
PURPOSE: Catheter-related bloodstream infection (CRBSI) is a serious complication associated with parenteral nutrition (PN). We retrospectively examined the features of CRBSI in patients with motility disorder (MD) by reviewing medical records. METHODS: Patients who received PN for more than 100 days in our hospital between January 2009 and September 2013 were reviewed. They were divided into two groups based on the presence or absence of MD. The frequency of CRBSI and the pathogenic organisms detected were compared. Statistical analysis was performed with the Mann-Whitney U test or Fisher's exact test. P < 0.05 was considered significant. RESULTS: Six patients had MD (MD group) and four patients had short bowels without MD (SB group). The median frequencies of CRBSI were 12.6 per 1,000 catheter-days in the MD group and 2.3 in the SB group (P = 0.027). The percentage of Gram-negative bacilli in all pathogenic organisms was 61% in the MD group and 22% in the SB group (P = 0.036). CONCLUSION: We found CRBSI was more frequent and Gram-negative bacilli were more common in patients with MD. Stasis in the alimentary tract and subsequent bacterial overgrowth appear to be risk factors for CRBSI. Therefore, it is crucial to seek treatments not to cause intestinal stasis.
PURPOSE: Catheter-related bloodstream infection (CRBSI) is a serious complication associated with parenteral nutrition (PN). We retrospectively examined the features of CRBSI in patients with motility disorder (MD) by reviewing medical records. METHODS:Patients who received PN for more than 100 days in our hospital between January 2009 and September 2013 were reviewed. They were divided into two groups based on the presence or absence of MD. The frequency of CRBSI and the pathogenic organisms detected were compared. Statistical analysis was performed with the Mann-Whitney U test or Fisher's exact test. P < 0.05 was considered significant. RESULTS: Six patients had MD (MD group) and four patients had short bowels without MD (SB group). The median frequencies of CRBSI were 12.6 per 1,000 catheter-days in the MD group and 2.3 in the SB group (P = 0.027). The percentage of Gram-negative bacilli in all pathogenic organisms was 61% in the MD group and 22% in the SB group (P = 0.036). CONCLUSION: We found CRBSI was more frequent and Gram-negative bacilli were more common in patients with MD. Stasis in the alimentary tract and subsequent bacterial overgrowth appear to be risk factors for CRBSI. Therefore, it is crucial to seek treatments not to cause intestinal stasis.
Authors: Samir S Shah; Kevin J Downes; Michael R Elliott; Louis M Bell; Karin L McGowan; Joshua P Metlay Journal: Pediatrics Date: 2008-01 Impact factor: 7.124