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- Title
Strategies for catheter-related blood stream infection based on medical course in children receiving parenteral nutrition.
- Authors
Sumida, Wataru; Watanabe, Yoshio; Takasu, Hidemi
- Abstract
Purpose: The central venous catheter (CVC) is a useful device for patients requiring parenteral nutrition (PN). However, the risk for catheter-related blood stream infection (CRBSI) is always present. We analyzed the medical course pattern and considered the strategies against febrile events in patients with CVC. Methods: Nine patients receiving PN in our institute from January 2009 to December 2010 were reviewed. Statistical analysis was performed with the Mann-Whitney U test. A p value of <0.05 was considered statistically significant. Results: Eighty-four febrile events were observed. Fifty-six specimens had a positive blood culture, and 52 (93%) specimens were found to be positive in 48 h. The fever dissolved within 48 h in 76 (90%) events after our scheduled treatment. Between the positive and negative blood culture groups, no statistical difference was observed in the count of white blood cell ( p = 0.15), the proportion of neutrophils ( p = 0.11) and C-reactive protein ( p = 0.64). None of the CVCs were removed because of failure to control infection. Conclusion: We recommend the treatment for CRBSI be initiated when patients with CVC develop a high-grade fever, even before exact identification of the cause of infection. The treatment can be corrected after the re-evaluation at 48 h.
- Subjects
CENTRAL venous catheters; PARENTERAL feeding; BLOOD diseases; QUANTITATIVE research; SCIENTIFIC observation; INFECTION in children
- Publication
Pediatric Surgery International, 2012, Vol 28, Issue 1, p21
- ISSN
0179-0358
- Publication type
Article
- DOI
10.1007/s00383-011-3009-y