乙醇封管疗法对儿童导管相关血流感染住院时间和导管挽救的影响。
The impact of ethanol lock therapy on length of stay and catheter salvage in pediatric catheter-associated bloodstream infection.
作者信息
Chaudhary Manu, Bilal Muhammad Fawad, Du Wei, Chu Roland, Rajpurkar Madhvi, McGrath Eric J
机构信息
Wayne State University School of Medicine; Children's Hospital of Michigan, Detroit, MI, USA.
Quaid-e-Azam Medical College, Bahawalpur, Pakistan.
出版信息
Clin Pediatr (Phila). 2014 Oct;53(11):1069-76. doi: 10.1177/0009922814533591. Epub 2014 May 7.
BACKGROUND
Ethanol lock therapy (ELT) with systemic antimicrobial therapy (SAT) is a treatment for catheter-associated bloodstream infections (CABSI). However, its impact on hospital length of stay (LOS) is unknown.
OBJECTIVES
Assess the impact of ELT on LOS, LOS attributable to CABSI (ALOS), and catheter salvage in pediatric hematology, oncology, stem cell transplant (HOSCT) CABSI.
METHODS
Retrospective review of HOSCT CABSI from January 2009 to July 2011.
RESULTS
A total of 124 CABSI episodes were reviewed in 66 patients. Mean LOS with ELT after 1 positive blood culture (BC) was 7.1 versus 12.3 days after ≥2 positive BC (P = .014). Mean ALOS was 1.6 days with ELT versus 2.9 days without ELT (P = .018). Mean ALOS with ELT after 1 positive BC was 3.75 days versus 5.8 days after ≥2 positive BC (P = .022). Catheter salvage rate: 41 of 48 (85%) with ELT versus 49 of 68 (72%) without ELT (P = .169).
CONCLUSION
Earlier initiation of ELT may decrease ALOS.
背景
乙醇封管疗法（ELT）联合全身抗菌治疗（SAT）是治疗导管相关血流感染（CABSI）的一种方法。然而，其对住院时间（LOS）的影响尚不清楚。
目的
评估ELT对儿科血液学、肿瘤学、干细胞移植（HOSCT）CABSI患者的住院时间、CABSI所致住院时间（ALOS）及导管挽救率的影响。
方法
回顾性分析2009年1月至2011年7月期间HOSCT患者发生的CABSI。
结果
共对66例患者的124次CABSI发作进行了评估。1次血培养（BC）阳性后接受ELT的患者平均住院时间为7.1天，≥2次BC阳性后为12.3天（P = 0.014）。ELT组的平均ALOS为1.6天，未接受ELT组为2.9天（P = 0.018）。1次BC阳性后接受ELT的患者平均ALOS为3.75天，≥2次BC阳性后为5.8天（P = 0.022）。导管挽救率：接受ELT的48例中有41例（85%），未接受ELT的68例中有49例（72%）（P = 0.169）。
结论
早期开始ELT可能会缩短ALOS。
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