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Central line-associated bloodstream infection among children with biliary atresia listed for liver transplantation

World Journal of Hepatology 2019年第2期11卷 208-216页

作者： Nicole D Triggs Stacey Beer Sonam Mokha kat hosek Danielle Guffey Charles G Minard Flor M Munoz Ryan W Himes Department of Pediatrics Section of GastroenterologyHepatologyand NutritionBaylor College of Medicine College of Arts and Sciences Washington University in St.Louis Outcomes and Impact Service Texas Children’s Hospital Dan L.Duncan Institute for Clinical and Translational Research Baylor College of Medicine Department of Pediatrics Section of Infectious DiseaseBaylor College of Medicine

BACKGROUND Pre-transplant nutrition is a key driver of outcomes following liver transplantation in *** with biliary atresia(BA) may have difficulty achieving satisfactory weight gain with enteral nutrition alone,and parenteral nutrition(PN) may be *** PN has been shown to improve anthropometric parameters of children with BA listed for liver transplantation,less is known about the risks,particularly infectious,associated with this therapy among this specific group of *** To describe the incidence,microbiology,and risk factors of central line-associated bloodstream infection(CLABSI) among children with BA listed for liver *** Retrospective review of children aged ≤ 2-years of age with BA who were listed for primary liver transplantation at Texas Children's Hospital from 2008 through2015(n = 96).Patients with a central line for administration of PN(n = 63) were identified and details of each CLABSI event were *** compared the group of patients who experienced CLABSI to the group who did not,to determine whether demographic,clinical,or laboratory factors correlated with development of *** Nineteen of 63 patients(30%,95%CI:19,43) experienced 29 episodes of CLABSI during 4800 line days(6.04 CLABSI per 1000 line days).CLABSI was predominantly associated with Gram-negative organisms(14/29 episodes,48%)including Klebsiella spp.,Enterobacter spp.,and Escherichia *** sole polymicrobial infection grew Enterobacter cloacae and Klebsiella *** organisms(all Staphylococcus spp.) and fungus(all Candida spp.)comprised 9/29(31%) and 6/29(21%) episodes,*** demographic,clinical,or laboratory factors were significantly associated with an increased risk for the first CLABSI event in Cox proportional hazards regression analysis CONCLUSION There is substantial risk for CLABSI among children with BA listed for liver *** clinical,demographic,or laboratory factor we

关键词： Parenteral nutrition Central line-associated bloodstream infection Pediatric Microbiology Central venous catheter

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