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Catheter-related bloodstream infections in children with intestinal failure: a 6-year review from an intestinal rehabilitation center in China

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Abstract

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.

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Data availability

We re-uploaded the original data through Springer Nature website and the data https://doi.org/10.11922/sciencedb.01531 (unregistered). Data private access link https://www.scidb.cn/en/s/eiiUvm.

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Funding

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), Foundation of Shanghai Municipal Health Commission (No. shslczdzk05702), Foundation of Science and Technology Commission of Shanghai Municipality (No. 19495810500) and Foundation of Clinical Research Plan of SHDC (No. SHDC2020CR2010A).

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Authors and Affiliations

  1. Division of Pediatric Gastroenterology and Nutrition, Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Rd., Shanghai, China

    Yi Cao, Wei-Hui Yan, Li-Na Lu, Yi-Jing Tao, Hai-Xia Feng, Qing-Qing Wu, Yi-Jing Chu, Wei Cai & Ying Wang

  2. Shanghai Institute for Pediatric Research, Shanghai, China

    Wei Cai

  3. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, No. 1665, Kongjiang Rd., Shanghai, China

    Wei Cai

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  1. Yi Cao
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  2. Wei-Hui Yan
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  7. Yi-Jing Chu
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  8. Wei Cai
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  9. Ying Wang
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Contributions

WY and CW equally contributed to the conception and design of the research. CY contributed to the design of the research and drafted the manuscript. YWH, LLN, and TYJ contributed to the acquisition and analysis of the data. FHX, WQQ, and CYJ contributed to the interpretation of the data. All authors critically revised the manuscript, agreed to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Corresponding authors

Correspondence to Wei Cai or Ying Wang.

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Ethical approval

This study was approved by the Ethics Committee of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (XHEC-C-2020–073).

Conflict of interest

No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article. Author CW is a member of the Editorial Board for World Journal of Pediatrics. The paper was handled by the other Editor and has undergone rigorous peer review process. Author CW was not involved in the journal's review of, or decisions related to, this manuscript.

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Cao, Y., Yan, WH., Lu, LN. et al. Catheter-related bloodstream infections in children with intestinal failure: a 6-year review from an intestinal rehabilitation center in China. World J Pediatr 18, 271–277 (2022). https://doi.org/10.1007/s12519-022-00519-3

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  • DOI: https://doi.org/10.1007/s12519-022-00519-3

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