Central Catheter‐related Bloodstream Infection Rates in Children on Home Parenteral Nutrition

Trivić, Ivana; Mišak, Zrinjka; Kerman, Višnjica; Prlić, Hrvoje; Kolaček, Sanja; Hojsak, Iva

doi:10.1097/mpg.0000000000002559

Cited by 7 publications

(5 citation statements)

References 17 publications

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“…The study flow chart is presented in Fig 1 . Eleven articles were selected for full-text analysis. Ten studies were excluded as two were retrospective studies [16,17], one was a non-RCT [18], one was a single-arm trial [19] while six studies were carried out on adult patients [20][21][22][23][24][25]. A total of four studies [26][27][28][29] were included in this systematic review and meta-analysis.…”

Section: Identification Of Relevant Studiesmentioning

confidence: 99%

Taurolidine lock solution for catheter-related bloodstream infections in pediatric patients: A meta-analysis

2020

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Infection is one of the most commonly described complications, and a major cause of morbidity and mortality in pediatric patients treated using central venous catheters (CVCs). Taurolidine lock solutions have been used to decrease catheter-related bloodstream infections (CRBSIs) in both adult and pediatric patients. The purpose of this study was to systematically search the literature and conduct a meta-analysis to determine the efficacy of taurolidine in reducing CRBSI in children. We conducted an electronic search of the PubMed, EMBASE, Cochrane Library, TRIP Database, CINAHL, and Google Scholar databases for articles published up to 1 st November 2019. Eligible studies included randomized controlled trials (RCTs) comparing the effects of taurolidine with control for preventing CRBSI in pediatric patients. Four studies were included. Our results indicated a statistical significant reduction in the total number of CRBSI with taurolidine as compared to control (RR: 0.23; 95% CI:0.13, 0.40; I 2 = 0%; P<0.00001). The pooled analysis also indicated a statistical significant reduction in the incidence of CRBSI (defined as the number of CRBSI events/1000 catheter days) in the taurolidine group (MD: -1.12; 95% CI:-1.54, -0.71; I 2 = 1%; P<0.00001). The number of catheters removed due to infection or suspected infection was not significantly different between the two groups (RR: 0.68; 95% CI:0.22, 2.10; I 2 = 56%; P = 0.50) (Fig 5). The quality of the included studies was not high. The use of taurolidine as a catheter locking solution may significantly reduce CRBSI in pediatric patients. However, the quality of current evidence is not high and further high-quality large scale RCTs are needed to corroborate our results.

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Section: Identification Of Relevant Studiesmentioning

confidence: 99%

Taurolidine lock solution for catheter-related bloodstream infections in pediatric patients: A meta-analysis

2020

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“…Catheter-related bloodstream infection (CRBSI) was defined as clinical evidence of a systemic infection and at least one positive blood culture from the CVC and/or peripheral vein in the absence of an obvious source of infection other than CVC (22). The CRBSI rate was calculated as the number of CRBSI episodes per 1000 catheter-days (23). CVC thrombosis was defined as the presence of at least one CVC site with thrombosis.…”

Section: Data Collection Definitions and Outcomesmentioning

confidence: 99%

Outcomes of the First 54 Pediatric Patients on Long-Term Home Parenteral Nutrition from a Single Brazilian Center

Goldani

Ceza²,

Godoy³

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: Data on multidisciplinary programs dedicated to home parenteral nutrition (HPN) in Latin America are limited. This study describes the results of the first multidisciplinary pediatric intestinal rehabilitation program for HPN at a public tertiary hospital in Brazil. Methods: We retrospectively reviewed patients aged 0-18 years with intestinal failure (IF) who required parenteral nutrition (PN) for >60 days between January/2014 and December/2020. Results: Fifty-four patients were discharged on HPN (15 achieved enteral autonomy, 34 continued on HPN at the end of the study, 1 underwent intestinal transplantation, and 4 died). The median (IQR) age at the study endpoint of patients who achieved enteral autonomy was 14.1 (9.7-19) versus 34.7 (20.4-53.9) months in those who did not achieve enteral autonomy. Overall prevalence of catheter-related thrombosis was 66.7% and catheterrelated bloodstream infection rate was 0.39/1000 catheter-days. Intestinal failure-associated liver disease (IFALD) was present in 24% of all patients; none of the patients who achieved enteral autonomy had IFALD. All patients showed significant improvement in anthropometric parameters during the HPN period. The sociodemographic characteristics of the patients' family members were mothers less than 20 years old (7.5%), schooling time more than 10 years (55.5%), and household income between 1 and 3 times the minimum wage (64.8%). The 5-year survival rate for HPN is 90%, and 27.7% of patients achieve enteral autonomy. Conclusion:The treatment of pediatric patients with IF followed by a multidisciplinary pediatric intestinal rehabilitation program with HPN is feasible and safe in the Brazilian public health system.

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“…For example, the incidence of catheter-related bloodstream infection (CRBSI) in Croatia was 1.15 per 1000 catheter-days from 2011 to 2019. Among them, nosocomial infection accounted for 2.35 per 1000 catheter-days, and HPN-related infection was 0.48 per 1000 catheter-days [ 3 ]. By implementing adequate central venous catheter (CVC) care protocols, CRBSI could be reduced and managed to save lives [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Home Parenteral Nutrition for Children: What Are the Factors Indicating Dependence and Mortality?

et al. 2023

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Parenteral nutrition (PN) in children with short bowel syndrome is crucial and lifesaving. Taking care of such patients requires interprofessional practice and multiple team resource management. Home PN (HPN) usage allows patients and families to live regular lives outside hospitals. We share our experiences for the last two decades and identify the risk factors for complications and mortality. A retrospective study of HPN patients was conducted between January 2000 and February 2022. Medical records of age, body weight, diagnosis, length of residual intestines, HPN period, central line attempts, complications, weaning, and survival were collected and analyzed. The patients were classified as HPN free, HPN dependent, and mortality groups. A total of 25 patients received HPN at our outpatient clinic, and one was excluded for the adult age of disease onset. There were 13 patients (54.1%) who were successfully weaned from HPN until the record-enroled date. The overall mortality rate was 20.8% (five patients). All mortality cases had prolonged cholestasis, Child Class B or C, and a positive Pediatric End-Stage Liver Disease (PELD) score. For HPN dependence, extended resection and multiple central line placement were two significant independent factors. Cholestasis, Child Class B or C, and positive PELD score were the most important risk factors for mortality. The central line-related complication rate was not different in all patient groups. The overall central line infection rate was 1.58 per 1000 catheter days. Caution should be addressed to prevent cholestasis and intestinal failure-associated liver disease during the HPN period, to prevent mortality. By understanding the risks of HPN dependence and mortality, preventive procedures could be addressed earlier.

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Central Catheter‐related Bloodstream Infection Rates in Children on Home Parenteral Nutrition

Cited by 7 publications

References 17 publications

Taurolidine lock solution for catheter-related bloodstream infections in pediatric patients: A meta-analysis

Taurolidine lock solution for catheter-related bloodstream infections in pediatric patients: A meta-analysis

Outcomes of the First 54 Pediatric Patients on Long-Term Home Parenteral Nutrition from a Single Brazilian Center

Home Parenteral Nutrition for Children: What Are the Factors Indicating Dependence and Mortality?

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