Colomb V, Fabeiro M, Dabbas M, Goulet O, Merckx J, Ricour C
Hôpital Necker-Enfants Malades, Paris, France.
Clin Nutr. 2000 Oct;19(5):355-9. doi: 10.1054/clnu.2000.0132.
This study aimed to assess the incidence and etiology of central venous catheter (CVC) infections in children on home parenteral nutrition (HPN).
207 CVC-years were studied retrospectively in 47 children on HPN, aged 8.1+/-5.0 years.
125 CVC were used (means: 2.6 CVC/patient and 21 months utilization/CVC). Half of the hospitalizations (162) were due to proven CVC-related infections. The mean infection incidence was 2. 1/1000 HPN days. The total population divided in two groups below and above this value: group one including 24 children, incidence < or = 2.1 per 1000 days (mean: 0.83) and group two including 23 children, incidence >2.1 per 1000 days (mean: 4.3). No differences were found between the two groups in terms of underlying disease, presence of ostomies, age at the time of HPN onset, or micro-organisms responsible. The only differences (p<0.05) were the mean duration of HPN (longer in group one) and the delay between HPN onset and the first infection (longer in group one).
This study does not highlight any risk factors for CVC infection. However, early CVC infections after HPN onset appear to predict a bad prognosis.
本研究旨在评估接受家庭肠外营养（HPN）的儿童中心静脉导管（CVC）感染的发生率及病因。
对47例接受HPN的儿童进行回顾性研究，共涉及207个CVC使用年，患儿年龄为8.1±5.0岁。
共使用了125根CVC（平均：2.6根CVC/患者，每根CVC使用21个月）。半数住院情况（162例）是由于已证实的与CVC相关的感染。平均感染发生率为2.1/1000个HPN日。将全部患儿分为感染发生率高于或低于该值的两组：第一组包括24名儿童，发生率≤2.1/1000日（平均：0.83）；第二组包括23名儿童，发生率>2.1/1000日（平均：4.3）。两组在基础疾病、造口情况、开始HPN时的年龄或致病微生物方面均未发现差异。唯一的差异（p<0.05）在于HPN的平均持续时间（第一组较长）以及开始HPN至首次感染的间隔时间（第一组较长）。
本研究未突出CVC感染的任何危险因素。然而，HPN开始后早期发生CVC感染似乎预示预后不良。
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