Incidence of catheter-associated gram-negative bacteremia in children with short bowel syndrome.

Children with catheter-associated bacteremia were evaluated for the type of bacteria recovered and the relationship of the bacteria to the predisposing disease. A previously unrecognized observation was that gram-negative isolates, namely, Escherichia coli and Klebsiella sp., were almost exclusively recovered (11 of 12 isolates [92%]) from children with short bowel syndrome (SBS) compared with those from children with other underlying diseases, such as inflammatory bowel disease, malignancies, and other disorders (P less than 0.001). Furthermore, children with SBS had a higher frequency of repeated infection (3.1 catheter-associated infections compared with 1.3 catheter-associated infections in children with other disorders during the same period). Only gram-positive bacteria were isolated from children with malignancies and other predisposing disorders. The very high frequency of catheter-associated gram-negative bacteremia in children with SBS compared with that in children with other bowel disorders, malignancies, and other predisposing diseases requires attention by the clinician in the management of patients in this group.