Central venous catheter-associated bloodstream infections in children diagnosed with intestinal failure in Southern Israel

Raouf Nassar, Guy Hazan, Eugene Leibovitz, Galina Ling, Isaac Lazar, Aya Khalaila, Yariv Fruchtman, Baruch Yerushalmi

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objectives: To study the clinical, epidemiological, and microbiological associations between intestinal failure (IF) and central line–associated infections (CLABSI) in patients with central vein catheters (CVCs) during 2005–2016. Methods: We compared retrospectively CLABSI rates according to background disease, type of line access, pathogen distribution, and antibiotic susceptibilities. Results: One hundred and fourteen children (64.1% < 4 years) were enrolled. Main diagnoses were persistent diarrhea (20, 17.5%), short bowel syndrome (13, 11.4%), continuous-TPN w/o diarrhea (11, 9.7%), very early–onset inflammatory bowel disease (VEO-IBD, 8, 7%), Hirschsprung’s disease (3, 2.6%), non-oncologic hematologic conditions (13, 11.4%), and other diseases (46, 40.4%). 152.749 catheter days were recorded; 71.1% had Hickman’s catheters. Two hundred and nine CLABSI episodes were recorded in 58 patients (82% with IF, 13.7 and 8.2/1000 catheter days in IF, and non-gastrointestinal conditions, P = 0.09). More CLABSI were recorded in continuous TPN vs. VEO-IBD or persistent diarrhea (38.8 vs.15.8 and 12.8/1000 catheter days, P < 0.004). Among patients with Hickman in jugular vein, highest CLBSI incidence was in continuous TPN, VEO-IBD, and persistent diarrhea (29.9, 15.84, and 12.49 episodes/1000 catheter days, respectively). CVCs were removed in 38.8% CLABSI. Two hundred and thirty-five pathogens were isolated (Enterobacteriaceae spp. in 39% of IF patients, mostly in persistent diarrhea and short bowel syndrome patients, 47.6% and 34.8%, respectively). Coagulase-negative Staphylococcus was the commonest pathogen in continuous TPN, VEO-IBD, and Hirschsprung’s (71.4%, 55.6% and 46.1%, respectively). Conclusions: CLABSI rates in IF patients were among the highest reported. We reported a “hierarchy” in CLABSI incidence among patients with IF and showed that CLABSI incidence and etiology were different as function of background diseases and CVC insertion site.

Original languageEnglish
Pages (from-to)517-525
Number of pages9
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume39
Issue number3
DOIs
StatePublished - 1 Mar 2020
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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