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Epidemiology and Risk Factors for Outpatient-Acquired Catheter-Related Bloodstream Infections in Children Receiving

Laura J Wozniak1, Hannah M Bechtold2, Laurie E Reyen3

  • 1Division of Pediatric Gastroenterology, Hepatology, and Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

JPEN. Journal of Parenteral and Enteral Nutrition
|February 16, 2018
PubMed

Insights

Catheter-related bloodstream infections (CRBSIs) are common in children receiving home parenteral nutrition, often presenting with fever. The presence of a feeding tube significantly increases the risk of developing these infections.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Epidemiology
  • Parenteral Nutrition

Background:

  • Outpatient-acquired catheter-related bloodstream infections (CRBSIs) are a significant concern in pediatric home parenteral nutrition (HPN).
  • Limited research exists on the epidemiology and risk factors for CRBSIs in this vulnerable population.

Purpose of the Study:

  • To characterize the incidence, clinical presentation, and epidemiology of CRBSIs in children on HPN.
  • To identify specific risk factors associated with CRBSI development in pediatric HPN patients.

Main Methods:

  • A prospective longitudinal database was utilized to track CRBSIs in pediatric patients (<18 years) receiving HPN.
  • Data collection occurred over a 12-month period (January-December 2012) at a single institution.

Main Results:

  • 50% of patients (30/60) experienced 66 CRBSIs, with an overall rate of 3.6 per 1000 catheter days.
  • Fever was the most common symptom (82%), followed by gastrointestinal (42%) and respiratory symptoms (29%).
  • The presence of a feeding tube was the sole significant multivariate risk factor, increasing CRBSI risk by 2.3-fold (p=0.04).

Conclusions:

  • CRBSIs are prevalent in children requiring HPN, frequently manifesting with fever.
  • Gastrointestinal and respiratory symptoms can also accompany CRBSIs in this cohort.
  • Co-existing feeding tubes represent a significant risk factor for CRBSI development in pediatric HPN patients.
Abstract

Keywords:
catheter-related bloodstream infectioncentral venous catheterhome nutrition supportparenteral nutritionpediatricssepsis

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