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Published on: September 20, 2019
[Risk factors of bloodstream infections associated with parenteral nutrition in pediatric patients]
P Balboa Cardemil1, C Castillo Durán
1Departamento de Pediatría, Facultad de Medicina, Campus Norte, Universidad de Chile, Hospital Roberto del Río, Santiago, Chile. pvbalboa@gmail.com
Insights
Bloodstream infections (BSI) linked to parenteral nutrition (PN) in children are primarily associated with longer PN duration. Malnutrition is a secondary risk factor for these infections in pediatric patients.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Nutrition
- Hospital Epidemiology
Background:
- Parenteral nutrition (PN) is essential for pediatric patients but carries a risk of bloodstream infections (BSI).
- Identifying key risk factors for PN-associated BSI is crucial for patient safety, especially in resource-limited settings.
- Previous research has not clearly established the most significant risk factors for PN-associated BSI in Chile.
Purpose of the Study:
- To investigate and identify the primary risk factors for bloodstream infections (BSI) associated with parenteral nutrition (PN) in pediatric patients.
- To analyze data from public hospitals in Santiago, Chile, to understand local epidemiology of PN-associated BSI.
- To inform clinical practice and improve preventative strategies for BSI in children receiving PN.
Main Methods:
- A retrospective case-control study was conducted in two public hospitals in Santiago, Chile, from January 2002 to December 2005.
- Patients receiving PN were analyzed, with cases defined as those with positive blood cultures during PN and controls as those with negative blood cultures.
- Statistical analyses included parametric, nonparametric, and stepwise logistic regression to identify significant risk factors.
Main Results:
- The study identified 58 cases and 130 controls. Patients with BSI received PN for a significantly longer duration (24 days vs. 10 days, p < 0.001).
- A higher rate of malnutrition was observed in the case group (44.4% vs. 31%, p < 0.05).
- Logistic regression analysis revealed that the duration of PN (in weeks) was the only statistically significant predictor of BSI (OR: 1.55, p < 0.05).
Conclusions:
- Longer duration of parenteral nutrition is a significant risk factor for bloodstream infections in pediatric patients in Santiago, Chile.
- The child's nutritional status (compromise) is a less significant, but still relevant, contributing factor to PN-associated BSI.
- Findings underscore the importance of monitoring PN duration and nutritional status to prevent BSI in vulnerable pediatric populations.
Introduction:
One of the complications of parenteral nutrition (PN) is bloodstream infection (BSI) associated with catheter, unknown the most important risk factors in our country.
Objective:
To determine risk factors of BSI associated with PN in pediatric patients in public hospitals of Santiago, Chile.
Patients And Methods:
In two public hospitals all newborns and children receiving PN were analyzed retrospectively, from January 2002 to December 2005. The study group (SG) was formed by all those with blood cultures (+) during the administration of PN. We selected two controls for each case, children with PN and blood cultures (-) (control group, CG). We used parametric, nonparametric and logistic regression to analyze data.
Results:
There were 58 cases and 130 controls. Children of the SG received PN for longer days than CG: 24 (7-934) vs. 10 days (7-152) (p < 0.001), presented a higher rate of malnutrition (44.4% vs. 31%, chi2, p < 0.05) and received more frequently PN by central venous catheter than peripheral catheter (GE: 60.3% and 6.9% vs. GC: 40.9% and 16.9% respectively, chi2, p < 0.01), without differences between newborns and older children. The stepwise logistic regression showed that the only significant variable was the duration of PN in weeks (OR: 1.55,95% CI 1.28 to 1.9; p < 0,05).
Conclusions:
The blood stream infections associated with parenteral nutrition in children in public hospitals of Santiago, are associated with longer duration of parenteral nutrition and in less degree to the child's nutritional compromise.
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