Aysenur Demirok MD, David H. C. Illy BS, Sietse Q. Nagelkerke MD, PhD, Michiel F. Lagerweij MS, Marc A. Benninga MD, PhD, Merit M. Tabbers MD, PhD
{"title":"接受家庭肠外营养的慢性肠功能衰竭患儿因金黄色葡萄球菌引起的导管相关血流感染中的导管挽救或移除以及预防性滔罗立定导管锁定溶液的使用：一项描述性队列研究","authors":"Aysenur Demirok MD, David H. C. Illy BS, Sietse Q. Nagelkerke MD, PhD, Michiel F. Lagerweij MS, Marc A. Benninga MD, PhD, Merit M. Tabbers MD, PhD","doi":"10.1002/jpen.2630","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Children with chronic IF require long-term home parenteral nutrition (HPN), administered through a central venous catheter. Catheter-related bloodstream infection (CRBSI) with <i>Staphylococcus aureus</i> is known to be a serious infection with a high mortality rate and risk of complications. A standardized protocol on the management of <i>S aureus</i> CRBSIs in children receiving HPN is lacking. The aim of this study is to evaluate the effectiveness and safety of the current management in an HPN expertise center in the Netherlands.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We performed a retrospective descriptive cohort study between 2013 and 2022 on children 0–18 years of age with chronic IF requiring long-term HPN. Our primary outcomes were the incidence of <i>S aureus</i> CRBSI per 1000 catheter days, catheter salvage attempt rate, and successful catheter salvage rate. Our secondary outcomes included complications and mortality.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 74 patients (39 male; 53%) were included, covering 327.8 catheter years. Twenty-eight patients (38%) had a total of 52 <i>S aureus</i> CRBSIs, with an incidence rate of 0.4 per 1000 catheter days. The catheter salvage attempt rate was 44% (23/52). The successful catheter salvage rate was 100%. No relapse occurred, and no removal was needed after catheter salvage. All complications that occurred were already present at admission before the decision to remove the catheter or not. No patients died because of an <i>S aureus</i> CRBSI.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Catheter salvage in <i>S aureus</i> CRBSIs in children receiving HPN can be attempted after careful consideration by a multidisciplinary team in an HPN expertise center.</p>\n </section>\n </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2630","citationCount":"0","resultStr":"{\"title\":\"Catheter salvage or removal in catheter-related bloodstream infections with Staphylococcus aureus in children with chronic intestinal failure receiving home parenteral nutrition and the use of prophylactic taurolidine catheter lock solution: A descriptive cohort study\",\"authors\":\"Aysenur Demirok MD, David H. C. Illy BS, Sietse Q. Nagelkerke MD, PhD, Michiel F. Lagerweij MS, Marc A. Benninga MD, PhD, Merit M. Tabbers MD, PhD\",\"doi\":\"10.1002/jpen.2630\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Children with chronic IF require long-term home parenteral nutrition (HPN), administered through a central venous catheter. Catheter-related bloodstream infection (CRBSI) with <i>Staphylococcus aureus</i> is known to be a serious infection with a high mortality rate and risk of complications. A standardized protocol on the management of <i>S aureus</i> CRBSIs in children receiving HPN is lacking. The aim of this study is to evaluate the effectiveness and safety of the current management in an HPN expertise center in the Netherlands.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We performed a retrospective descriptive cohort study between 2013 and 2022 on children 0–18 years of age with chronic IF requiring long-term HPN. Our primary outcomes were the incidence of <i>S aureus</i> CRBSI per 1000 catheter days, catheter salvage attempt rate, and successful catheter salvage rate. Our secondary outcomes included complications and mortality.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 74 patients (39 male; 53%) were included, covering 327.8 catheter years. Twenty-eight patients (38%) had a total of 52 <i>S aureus</i> CRBSIs, with an incidence rate of 0.4 per 1000 catheter days. The catheter salvage attempt rate was 44% (23/52). The successful catheter salvage rate was 100%. No relapse occurred, and no removal was needed after catheter salvage. All complications that occurred were already present at admission before the decision to remove the catheter or not. 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Catheter salvage or removal in catheter-related bloodstream infections with Staphylococcus aureus in children with chronic intestinal failure receiving home parenteral nutrition and the use of prophylactic taurolidine catheter lock solution: A descriptive cohort study
Background
Children with chronic IF require long-term home parenteral nutrition (HPN), administered through a central venous catheter. Catheter-related bloodstream infection (CRBSI) with Staphylococcus aureus is known to be a serious infection with a high mortality rate and risk of complications. A standardized protocol on the management of S aureus CRBSIs in children receiving HPN is lacking. The aim of this study is to evaluate the effectiveness and safety of the current management in an HPN expertise center in the Netherlands.
Methods
We performed a retrospective descriptive cohort study between 2013 and 2022 on children 0–18 years of age with chronic IF requiring long-term HPN. Our primary outcomes were the incidence of S aureus CRBSI per 1000 catheter days, catheter salvage attempt rate, and successful catheter salvage rate. Our secondary outcomes included complications and mortality.
Results
A total of 74 patients (39 male; 53%) were included, covering 327.8 catheter years. Twenty-eight patients (38%) had a total of 52 S aureus CRBSIs, with an incidence rate of 0.4 per 1000 catheter days. The catheter salvage attempt rate was 44% (23/52). The successful catheter salvage rate was 100%. No relapse occurred, and no removal was needed after catheter salvage. All complications that occurred were already present at admission before the decision to remove the catheter or not. No patients died because of an S aureus CRBSI.
Conclusion
Catheter salvage in S aureus CRBSIs in children receiving HPN can be attempted after careful consideration by a multidisciplinary team in an HPN expertise center.
期刊介绍：
The Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or IV therapies. Also included: reviews, techniques, brief reports, case reports, and abstracts.
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