Background Children with intestinal failure(IF)have frequent catheter-related bloodstream infections(CRBSIs).This study aimed to analyze the clinical presentation and laboratory parameters of CRBSIs in children with I...Background Children with intestinal failure(IF)have frequent catheter-related bloodstream infections(CRBSIs).This study aimed to analyze the clinical presentation and laboratory parameters of CRBSIs in children with IF.Methods This 6-year retrospective study was conducted among IF children with CRBSIs at an intestinal rehabilitation center in China.Clinical data were collected,including data of temperature and gastrointestinal symptoms.Blood/catheter culture,fecal tests,and calculation of inflammatory index were performed,which were obtained within 1 week since CRBSI onset.Results Fifty children with 87 CRBSIs were identified,of which there were 17 suspected and 70 confirmed cases.Seventy-two pathogens were cultured from 70 positive blood cultures:63%were Gram-positive organisms,23%were Gram-negative organisms,and 11%were fungal organisms.Overall,48.6%were enteric organisms;47.2%of bacterial pathogens were consistent between fecal and blood cultures.Moreover,46.3%fecal routines showed abnormalities including increased white blood cells,occult blood positive and the presence of fat droplets.The consistent symptom at onset of CRBSIs was fever and gastrointestinal symptoms including increased stool output,abdominal distension,or both.C-reactive protein(CRP)and procalcitonin(PCT)were elevated,i.e.,16.5 mg/L[interquartile range(IQR)8.7-44.7]and 0.48 ng/mL(IQR 0.2-1.76),respectively.Conclusions IF children had a high rate of CRBSIs,of which larger proportions were due to Gram-positive and enteric organisms.Fever and/or gastrointestinal symptoms,combined with elevated CRP and PCT,is conducive to the early diagnosis of CRBSIs in IF patients.展开更多
基金This study is supported by National Natural Science Foundation of China(Nos.81974066,81630039)Foundation of Shanghai Municipal Health Commission(Key Weak Discipline Construction Project,2019ZB0101)+2 种基金Foundation of Shanghai Municipal Health Commission(No.shslczdzk05702)Foundation of Science and Technology Commission of Shanghai Municipality(No.19495810500)Foundation of Clinical Research Plan of SHDC(No.SHDC2020CR2010A).
文摘Background Children with intestinal failure(IF)have frequent catheter-related bloodstream infections(CRBSIs).This study aimed to analyze the clinical presentation and laboratory parameters of CRBSIs in children with IF.Methods This 6-year retrospective study was conducted among IF children with CRBSIs at an intestinal rehabilitation center in China.Clinical data were collected,including data of temperature and gastrointestinal symptoms.Blood/catheter culture,fecal tests,and calculation of inflammatory index were performed,which were obtained within 1 week since CRBSI onset.Results Fifty children with 87 CRBSIs were identified,of which there were 17 suspected and 70 confirmed cases.Seventy-two pathogens were cultured from 70 positive blood cultures:63%were Gram-positive organisms,23%were Gram-negative organisms,and 11%were fungal organisms.Overall,48.6%were enteric organisms;47.2%of bacterial pathogens were consistent between fecal and blood cultures.Moreover,46.3%fecal routines showed abnormalities including increased white blood cells,occult blood positive and the presence of fat droplets.The consistent symptom at onset of CRBSIs was fever and gastrointestinal symptoms including increased stool output,abdominal distension,or both.C-reactive protein(CRP)and procalcitonin(PCT)were elevated,i.e.,16.5 mg/L[interquartile range(IQR)8.7-44.7]and 0.48 ng/mL(IQR 0.2-1.76),respectively.Conclusions IF children had a high rate of CRBSIs,of which larger proportions were due to Gram-positive and enteric organisms.Fever and/or gastrointestinal symptoms,combined with elevated CRP and PCT,is conducive to the early diagnosis of CRBSIs in IF patients.
