短肠综合征儿童导管相关性血流感染的单中心回顾性研究

Catheter-related bloodstream infections in children with short bowel syndrome:a single-center retrospective study

目的评估儿童短肠综合征(SBS)导管相关血流感染(CRBSI)的发生率和危险因素。方法回顾性分析2015年8月至2019年12月收治的19例SBS患儿的临床资料,评估CRBSI的发生率和相关危险因素。结果在19例SBS患儿中,共置管57次,总置管日为1907天,其中6例患儿共发生11次CRBSI,发生率为5.8次/1000导管日。SBS患儿CRBSI的常见表现为发热(6/11,54.5%)、嗜睡(5/11,45.4%)、体质量不增(7/11,63.6%)和肠造瘘量增加(7/11,63.6%)。与未发生CRBSI组相比,CRBSI组SBS患儿的回盲瓣缺失以及肠外营养持续时间≥120天的比例更高,差异均有统计学意义(P<0.05)。SBS患儿发生CRBSI时的血培养共获得11次阳性结果,最常见的病原微生物为肺炎克雷伯杆菌(6/11,54.55%)。结论CRBSI发生可能与回盲瓣缺失和肠外营养持续时间长有关。

Objective To explore the incidence and risk factors of catheter-related bloodstream infection(CRBSI)in children with short bowel syndrome(SBS).Methods The clinical data of SBS in 19 children admitted from August 2015 to December 2019 was retrospectively analyzed and the incidence of CRBSI and related risk factors were evaluated.Results Among the 19 children with SBS,the catheterization was performed 57 times,and the total catheterization days were 1907 days.CRBSI occurred 11 times in 6 children,with an incidence of 5.8 times per 1000 catheter days.The common manifestations of the SBS children with CRBSI were fever(6/11,54.5%),lethargy(5/11,45.4%),stagnation of weight(7/11,63.6%)and increment of enterostomy fluid(7/11,63.6%).Compared with the non-CRBSI group,the proportion of ileocecal valve loss and the duration of parenteral nutrition ≥120 days in the CRBSI group were higher,and the differences were statistically significant(P<0.05).A total of 11 positive results were obtained in blood culture of children with SBS when CRBSI occurred,and the most common pathogenic microorganism was Klebsiella pneumoniae(6/11,54.55%).Conclusions The occurrence of CRBSI may be related to ileocecal valve loss and long duration of parenteral nutrition.