Kara Tuğçe Tural, Özdemir Halil, Erat Tuğba, Yahşi Aysun, Aysev Ahmet Derya, Taçyıldız Nurdan, Ünal Emel, İleri Talia, İnce Elif, Haskoloğlu Şule, Çiftçi Ergin, İnce Erdal
Departments of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey.
Departments of Microbiology Laboratory, Ankara University Faculty of Medicine, Ankara, Turkey.
Turk J Pediatr. 2019;61(6):895-904. doi: 10.24953/turkjped.2019.06.011.
Tural Kara T, Özdemir H, Erat T, Yahşi A, Aysev AD, Taçyıldız N, Ünal E, İleri T, İnce E, Haskoloğlu Ş, Çiftçi E, İnce E. Is antibiotic lock therapy effective for the implantable long-term catheter-related bloodstream infections in children? Turk J Pediatr 2019; 61: 895-904. Catheter-related bloodstream infections (CRBSIs) are an important problem in pediatric patients with central venous catheters. This study aimed to determine the incidence of CRBSIs, responsible pathogens and outcomes of antibiotic lock treatment (ALT) in pediatric patients. Between January 2010 and November 2015 all hospitalized pediatric hematology, oncology and immunology patients diagnosed with CRBSIs were retrospectively analyzed. Seventy-eight CRBSI episodes were detected in 60 pediatric patients. The incidence of CRBSIs was 4.20/1000 catheter days. The most frequently detected pathogen was methicillin-resistant coagulase-negative Staphylococcus. Pseudomonas aeruginosa, Klebsiella spp., and Escherichia coli were other commonly isolated microorganisms. ALT was administered in 42 patients. The success rate of ALT was 81% (34/42). Catheter was removed without ALT in 36 episodes. Common reasons for catheter removal were sepsis and causative microorganisms which had high probability of biofilm formation. CRBSIs are an important cause of morbidity and mortality in pediatric patients. ALT is safe and effective. It is possible to obtain satisfactory results when ALT is used with intravenous systemic antibiotics for CRBSIs, though in some cases catheter removal is necessary. ALT helps to prevent unnecessary catheter removal in pediatric patients.
图拉尔·卡拉T、奥兹德米尔H、埃拉特T、亚希A、艾塞夫AD、塔西尔迪兹N、于纳尔E、伊勒里T、因斯E、哈斯科洛古卢Ş、奇夫特奇E、因斯E。抗生素封管疗法对儿童植入式长期导管相关血流感染有效吗？《土耳其儿科学杂志》2019年；61: 895 - 904。导管相关血流感染（CRBSIs）是儿科中心静脉导管患者的一个重要问题。本研究旨在确定儿科患者中CRBSIs的发生率、致病病原体以及抗生素封管治疗（ALT）的结果。对2010年1月至2015年11月期间所有住院的诊断为CRBSIs的儿科血液学、肿瘤学和免疫学患者进行回顾性分析。在60名儿科患者中检测到78次CRBSI发作。CRBSIs的发生率为4.20/1000导管日。最常检测到的病原体是耐甲氧西林凝固酶阴性葡萄球菌。铜绿假单胞菌、克雷伯菌属和大肠杆菌是其他常见分离出的微生物。42名患者接受了ALT治疗。ALT的成功率为81%（34/42）。36次发作未进行ALT而拔除了导管。拔除导管的常见原因是败血症和有高生物膜形成可能性的致病微生物。CRBSIs是儿科患者发病和死亡的重要原因。ALT安全有效。当ALT与静脉全身用抗生素联合用于CRBSIs时有可能获得满意结果，尽管在某些情况下有必要拔除导管。ALT有助于防止儿科患者不必要的导管拔除。
