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Updated: Dec 23, 2025
Assessment of Intestinal Transcytosis of Neonatal Escherichia coli Bacteremia Isolates
Published on: February 17, 2023
The implication of intestinal bacterial translocation in central line associated blood stream infections in the
Fuad C Haddad1, Raghavendra Rao1, Sandeep Kaur2
1Indiana University School of Medicine, Indianapolis, Indiana.
Insights
Bacterial translocation from the gut may increase central line-associated bloodstream infections (CLABSI) in pediatric patients after gastrointestinal surgery (GIS). Coagulase-negative staphylococcus was more common in GIS patients, but outcomes were similar across groups.
Area of Science:
- Infectious Diseases
- Pediatric Surgery
- Microbiology
Background:
- Bacterial intestinal translocation is a known factor in neonatal sepsis.
- The role of translocation in central line-associated bloodstream infections (CLABSI) in pediatric patients undergoing gastrointestinal surgery (GIS) requires further investigation.
Purpose of the Study:
- To determine the significance of bacterial translocation in causing CLABSI in pediatric patients who underwent GIS.
- To compare the microbial profiles and clinical outcomes of CLABSI in patients with GIS, non-GI surgery (NGIS), and no surgery (NS).
Main Methods:
- A retrospective analysis of pediatric patients with CLABSI was conducted.
- Patients were categorized into GIS, NGIS, and NS groups.
- Data collected included organism type, resistance patterns, CLABSI clearance, antibiotic therapy, and patient demographics.
Main Results:
- Coagulase-negative staphylococcus (CoNS) was the most frequent organism (32%), significantly more common in the GIS group (58%) compared to NGIS (9%) and NS (29%) groups (p=0.04).
- Gastrointestinal surgery patients were more likely to have a central line during surgery (80%).
- No significant differences were observed in bacteremia resolution time, mortality, or central line removal necessity across the groups.
Conclusions:
- Findings suggest a potential link between gastrointestinal surgery and a higher incidence of CoNS in CLABSI.
- This information can guide preventive strategies for CLABSI in pediatric patients with central lines undergoing GIS.
Introduction:
Bacterial intestinal translocation plays an important role in neonatal sepsis. We aimed to elucidate the importance of such translocation in causing central line associated blood stream infection (CLABSI) in patients undergoing gastrointestinal surgery (GIS).
Methods:
Using a database of pediatric patients with CLABSI, patients were divided into those who had a GI-surgery (where intestines were opened), those who had a non-GI-surgery (NGIS; all other types of surgery) and those who had no surgery (NS). Data regarding type of organisms isolated on culture, their resistance patterns, clearance of CLABSI, type of antibiotic therapy and patient demographics were collected.
Results:
117 CLABSIs were identified between 2011 and 2018. 26 patients had GIS, 22 had NGIS and 69 had NS. NS patients were younger. 80% of GIS and NGIS patients had a central line at the time of surgery. Coagulase-negative staphylococcus (CoNS) was the most common organism isolated (32%). CoNS was more common in GIS compared to NGIS and NS (58% vs. 9% vs. 29% respectively, p=0.04). There were no differences in the time to resolution of bacteremia, mortality rates or need to remove the central line.
Conclusions:
This information should help inform efforts for prevention of CLABSIs in patients undergoing GI surgery with central lines present.
Level Of Evidence:
III.
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