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Central line associated sepsis in children receiving parenteral nutrition in Oman
Tawfiq T Al Lawati1, Adawaiya Al Jamie2, Nasra Al Mufarraji2
1Royal Hospital, PO Box 1331, PC: 111, Muscat, Oman.
Insights
Parenteral nutrition (PN) in children is linked to high rates of central line-associated bloodstream infections (CLABSI) and mortality. Urgent implementation of central line care bundles is recommended.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Nutrition
Background:
- Parenteral nutrition (PN) is essential for patients with gastrointestinal failure.
- Central line-associated bloodstream infections (CLABSI) are a significant complication of PN therapy.
- Limited data exists on CLABSI incidence and mortality in pediatric PN patients in the Royal Hospital.
Purpose of the Study:
- To determine the incidence of CLABSI in children receiving PN.
- To assess the mortality associated with CLABSI in this population.
- To investigate the indications and duration of PN use in pediatric patients.
Main Methods:
- Retrospective analysis of electronic health records.
- Inclusion criteria: children aged 0-48 months receiving total parenteral nutrition (TPN) outside the NICU between 2011 and 2014.
- Data collected on PN duration, indications, CLABSI incidence, and mortality.
Main Results:
- 42 children received PN for a total of 569 days.
- CLABSI incidence was 14 per 1000 catheter days.
- Mortality rate was 556 per 10,000.
- Average TPN duration was 14.5 days, with cardiac conditions being the most common indication.
Conclusions:
- Despite short-term PN use, CLABSI incidence and associated mortality are high in pediatric patients.
- The Royal Hospital does not utilize a central line care bundle policy.
- Urgent implementation of a central line care bundle is crucial to reduce CLABSI and mortality.
Abstract:
Parenteral Nutrition (PN) is used when gut fails to provide complete nutrition. Central line Associate Blood Stream Infection (CLABSI) a major complication of this therapy. The objective of the study was to report the incidence of CLABSI and associated mortality in children receiving PN in the Royal Hospital and study the indication and duration of PN use. All children from the age of 0-48 months who received TPN outside NICU from the period between 1/1/2011 till 31/12/2014 were included. Data were retrieved from the hospital electronic data base. There were 42 children 27 males and 15 females who used PN through a central line for a total duration of 569 days. The incidence of CLABSI was 14 days per 1000 days catheter and mortality of 556 per 10000. The average duration of TPN was 14.5 days. Most of the patient had CLABSI in the PICU and cardiac related illness or surgery was the most common indication of PN use. The average duration of use was 14 days. Inspite of that short duration use of PN, there is a very high incidence of CLABSI and its related mortality. Bundle policy for central line care is not used in the Royal Hospital and this study calls for urgent implementation of central line care bundle policy in the Royal Hospital.
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