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Prevention of catheter-related bacteremia in pediatric intestinal transplantation/short gut syndrome children with long-term central venous catheters
: Catheter‐related bacteremia (CRB), along with liver failure is the leading cause of mortality and morbidity in parenteral nutrition dependent children. Immunosuppressant therapy following transplantation increases the risk of CRB. Previous reports in pediatric cancer patients have described the u...
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| Published in: | Pediatric transplantation 2007-02, Vol.11 (1), p.87-93 |
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| container_end_page | 93 |
| container_issue | 1 |
| container_start_page | 87 |
| container_title | Pediatric transplantation |
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| creator | Onder, Ali Mirza Kato, Tomoaki Simon, Nancy Rivera-Hernandez, Maria Chandar, Jayanthi Montane, Brenda Francoeur, Denise Salvaggi, Genaro Tzakis, Andreas G. Zilleruelo, Gaston |
| description | : Catheter‐related bacteremia (CRB), along with liver failure is the leading cause of mortality and morbidity in parenteral nutrition dependent children. Immunosuppressant therapy following transplantation increases the risk of CRB. Previous reports in pediatric cancer patients have described the use of antibiotic lock solutions (ABL) for prophylaxis of CRB. In our institution, we evaluated five children (ages between one and four yr old), three with intestinal transplantation and two with short gut syndrome, who were high risk for recurrent CRB defined by their incidence of bacteremias in the observation period (>2 CRB/six months or life‐threatening CRB). These children received the prophylactic ABL protocol with tobramycin‐tissue plasminogen activator, four h per day, on alternating ports for six to eight months. Each patient was his/her own historical control. We observed decreased incidence of CRB's (p |
| doi_str_mv | 10.1111/j.1399-3046.2006.00634.x |
| format | article |
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Immunosuppressant therapy following transplantation increases the risk of CRB. Previous reports in pediatric cancer patients have described the use of antibiotic lock solutions (ABL) for prophylaxis of CRB. In our institution, we evaluated five children (ages between one and four yr old), three with intestinal transplantation and two with short gut syndrome, who were high risk for recurrent CRB defined by their incidence of bacteremias in the observation period (>2 CRB/six months or life‐threatening CRB). These children received the prophylactic ABL protocol with tobramycin‐tissue plasminogen activator, four h per day, on alternating ports for six to eight months. Each patient was his/her own historical control. We observed decreased incidence of CRB's (p < 0.05), days of hospitalization due to CRB's (p < 0.0001), the days of intensive care admissions due to CRB (p < 0.0001), as well as the total days of systemic antibiotic exposure (p < 0.001). Catheter survival during the ABL era was longer but not reaching statistical significance. There was no advantage in removing and later replacing the catheter to wire‐guided exchange while on systemic antibiotics. One patient presented with break‐through bacteremia, septic shock and died. None of the catheters were lost to occlusion/malfunction. ABL did not induce an increased resistance to tobramycin. These preliminary findings suggest that ABL can be used safely and effectively in parenteral nutrition dependent children with long‐term central venous catheters.</description><identifier>ISSN: 1397-3142</identifier><identifier>EISSN: 1399-3046</identifier><identifier>DOI: 10.1111/j.1399-3046.2006.00634.x</identifier><identifier>PMID: 17239129</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>antibiotic-lock solutions ; Bacteremia - prevention & control ; Bacterial diseases ; Bacterial sepsis ; Biological and medical sciences ; catheter survival ; catheter-related bacteremia ; Catheterization, Central Venous - adverse effects ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Human bacterial diseases ; Humans ; Infant ; Infectious diseases ; Intestines - transplantation ; Kidney Transplantation ; Liver Transplantation ; Male ; Medical sciences ; parenteral nutrition ; Prevention and actions ; prophylaxis ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Retrospective Studies ; Short Bowel Syndrome - surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><ispartof>Pediatric transplantation, 2007-02, Vol.11 (1), p.87-93</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4354-8df9e45ab04ae03ef77081053a03c1258368abea87b7033de951e32b4adbcf823</citedby><cites>FETCH-LOGICAL-c4354-8df9e45ab04ae03ef77081053a03c1258368abea87b7033de951e32b4adbcf823</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18485706$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17239129$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Onder, Ali Mirza</creatorcontrib><creatorcontrib>Kato, Tomoaki</creatorcontrib><creatorcontrib>Simon, Nancy</creatorcontrib><creatorcontrib>Rivera-Hernandez, Maria</creatorcontrib><creatorcontrib>Chandar, Jayanthi</creatorcontrib><creatorcontrib>Montane, Brenda</creatorcontrib><creatorcontrib>Francoeur, Denise</creatorcontrib><creatorcontrib>Salvaggi, Genaro</creatorcontrib><creatorcontrib>Tzakis, Andreas G.</creatorcontrib><creatorcontrib>Zilleruelo, Gaston</creatorcontrib><title>Prevention of catheter-related bacteremia in pediatric intestinal transplantation/short gut syndrome children with long-term central venous catheters</title><title>Pediatric transplantation</title><addtitle>Pediatr Transplant</addtitle><description>: Catheter‐related bacteremia (CRB), along with liver failure is the leading cause of mortality and morbidity in parenteral nutrition dependent children. Immunosuppressant therapy following transplantation increases the risk of CRB. Previous reports in pediatric cancer patients have described the use of antibiotic lock solutions (ABL) for prophylaxis of CRB. In our institution, we evaluated five children (ages between one and four yr old), three with intestinal transplantation and two with short gut syndrome, who were high risk for recurrent CRB defined by their incidence of bacteremias in the observation period (>2 CRB/six months or life‐threatening CRB). These children received the prophylactic ABL protocol with tobramycin‐tissue plasminogen activator, four h per day, on alternating ports for six to eight months. Each patient was his/her own historical control. We observed decreased incidence of CRB's (p < 0.05), days of hospitalization due to CRB's (p < 0.0001), the days of intensive care admissions due to CRB (p < 0.0001), as well as the total days of systemic antibiotic exposure (p < 0.001). Catheter survival during the ABL era was longer but not reaching statistical significance. There was no advantage in removing and later replacing the catheter to wire‐guided exchange while on systemic antibiotics. One patient presented with break‐through bacteremia, septic shock and died. None of the catheters were lost to occlusion/malfunction. ABL did not induce an increased resistance to tobramycin. These preliminary findings suggest that ABL can be used safely and effectively in parenteral nutrition dependent children with long‐term central venous catheters.</description><subject>antibiotic-lock solutions</subject><subject>Bacteremia - prevention & control</subject><subject>Bacterial diseases</subject><subject>Bacterial sepsis</subject><subject>Biological and medical sciences</subject><subject>catheter survival</subject><subject>catheter-related bacteremia</subject><subject>Catheterization, Central Venous - adverse effects</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Intestines - transplantation</subject><subject>Kidney Transplantation</subject><subject>Liver Transplantation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>parenteral nutrition</subject><subject>Prevention and actions</subject><subject>prophylaxis</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Retrospective Studies</subject><subject>Short Bowel Syndrome - surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><issn>1397-3142</issn><issn>1399-3046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><recordid>eNqNUV1v0zAUjRCIjcJfQH6Bt2R27MTOAw9ojA5pggoVIfFi3Tg3q0s-Ottl7Q_Z_52zVt0rlizfK59z7sdJEsJoxuK5WGeMV1XKqSiznNIyi5eLbPciOT99vHyKZcqZyM-SN96vKWWlUOJ1csZkziuWV-fJw8LhPxyCHQcytsRAWGFAlzrsIGBDajAxxd4CsQPZYGMhOGtiEtAHO0BHgoPBbzoYAkwyF341ukBut4H4_dC4sUdiVrZrHA7k3oYV6cbhNo2qPTGxsosSsYNx60_V_dvkVQudx3fHd5b8-nq1vLxOb37Mv11-vkmN4IVIVdNWKAqoqQCkHFspqWK04EC5YXmheKmgRlCylpTzBquCIc9rAU1tWpXzWfLxoLtx4902DqR76w12cRiMDelSVZxKRSNQHYDGjd47bPXG2R7cXjOqJ0v0Wk-b19Pm9WSJfrJE7yL1_bHGtu6xeSYePYiAD0cAeANdG9dprH_GKaEKGcVmyacD7t52uP_vBvTiavkzRpGfHvjWB9yd-OD-6lJyWejf3-f6-gufL5b5XP_hj34Muyo</recordid><startdate>200702</startdate><enddate>200702</enddate><creator>Onder, Ali Mirza</creator><creator>Kato, Tomoaki</creator><creator>Simon, Nancy</creator><creator>Rivera-Hernandez, Maria</creator><creator>Chandar, Jayanthi</creator><creator>Montane, Brenda</creator><creator>Francoeur, Denise</creator><creator>Salvaggi, Genaro</creator><creator>Tzakis, Andreas G.</creator><creator>Zilleruelo, Gaston</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200702</creationdate><title>Prevention of catheter-related bacteremia in pediatric intestinal transplantation/short gut syndrome children with long-term central venous catheters</title><author>Onder, Ali Mirza ; Kato, Tomoaki ; Simon, Nancy ; Rivera-Hernandez, Maria ; Chandar, Jayanthi ; Montane, Brenda ; Francoeur, Denise ; Salvaggi, Genaro ; Tzakis, Andreas G. ; Zilleruelo, Gaston</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4354-8df9e45ab04ae03ef77081053a03c1258368abea87b7033de951e32b4adbcf823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>antibiotic-lock solutions</topic><topic>Bacteremia - prevention & control</topic><topic>Bacterial diseases</topic><topic>Bacterial sepsis</topic><topic>Biological and medical sciences</topic><topic>catheter survival</topic><topic>catheter-related bacteremia</topic><topic>Catheterization, Central Venous - adverse effects</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infant</topic><topic>Infectious diseases</topic><topic>Intestines - transplantation</topic><topic>Kidney Transplantation</topic><topic>Liver Transplantation</topic><topic>Male</topic><topic>Medical sciences</topic><topic>parenteral nutrition</topic><topic>Prevention and actions</topic><topic>prophylaxis</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Retrospective Studies</topic><topic>Short Bowel Syndrome - surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Onder, Ali Mirza</creatorcontrib><creatorcontrib>Kato, Tomoaki</creatorcontrib><creatorcontrib>Simon, Nancy</creatorcontrib><creatorcontrib>Rivera-Hernandez, Maria</creatorcontrib><creatorcontrib>Chandar, Jayanthi</creatorcontrib><creatorcontrib>Montane, Brenda</creatorcontrib><creatorcontrib>Francoeur, Denise</creatorcontrib><creatorcontrib>Salvaggi, Genaro</creatorcontrib><creatorcontrib>Tzakis, Andreas G.</creatorcontrib><creatorcontrib>Zilleruelo, Gaston</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Onder, Ali Mirza</au><au>Kato, Tomoaki</au><au>Simon, Nancy</au><au>Rivera-Hernandez, Maria</au><au>Chandar, Jayanthi</au><au>Montane, Brenda</au><au>Francoeur, Denise</au><au>Salvaggi, Genaro</au><au>Tzakis, Andreas G.</au><au>Zilleruelo, Gaston</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevention of catheter-related bacteremia in pediatric intestinal transplantation/short gut syndrome children with long-term central venous catheters</atitle><jtitle>Pediatric transplantation</jtitle><addtitle>Pediatr Transplant</addtitle><date>2007-02</date><risdate>2007</risdate><volume>11</volume><issue>1</issue><spage>87</spage><epage>93</epage><pages>87-93</pages><issn>1397-3142</issn><eissn>1399-3046</eissn><abstract>: Catheter‐related bacteremia (CRB), along with liver failure is the leading cause of mortality and morbidity in parenteral nutrition dependent children. Immunosuppressant therapy following transplantation increases the risk of CRB. Previous reports in pediatric cancer patients have described the use of antibiotic lock solutions (ABL) for prophylaxis of CRB. In our institution, we evaluated five children (ages between one and four yr old), three with intestinal transplantation and two with short gut syndrome, who were high risk for recurrent CRB defined by their incidence of bacteremias in the observation period (>2 CRB/six months or life‐threatening CRB). These children received the prophylactic ABL protocol with tobramycin‐tissue plasminogen activator, four h per day, on alternating ports for six to eight months. Each patient was his/her own historical control. We observed decreased incidence of CRB's (p < 0.05), days of hospitalization due to CRB's (p < 0.0001), the days of intensive care admissions due to CRB (p < 0.0001), as well as the total days of systemic antibiotic exposure (p < 0.001). Catheter survival during the ABL era was longer but not reaching statistical significance. There was no advantage in removing and later replacing the catheter to wire‐guided exchange while on systemic antibiotics. One patient presented with break‐through bacteremia, septic shock and died. None of the catheters were lost to occlusion/malfunction. ABL did not induce an increased resistance to tobramycin. These preliminary findings suggest that ABL can be used safely and effectively in parenteral nutrition dependent children with long‐term central venous catheters.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>17239129</pmid><doi>10.1111/j.1399-3046.2006.00634.x</doi><tpages>7</tpages></addata></record> |
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| ispartof | Pediatric transplantation, 2007-02, Vol.11 (1), p.87-93 |
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| subjects | antibiotic-lock solutions Bacteremia - prevention & control Bacterial diseases Bacterial sepsis Biological and medical sciences catheter survival catheter-related bacteremia Catheterization, Central Venous - adverse effects Child Child, Preschool Female Follow-Up Studies Human bacterial diseases Humans Infant Infectious diseases Intestines - transplantation Kidney Transplantation Liver Transplantation Male Medical sciences parenteral nutrition Prevention and actions prophylaxis Public health. Hygiene Public health. Hygiene-occupational medicine Retrospective Studies Short Bowel Syndrome - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases |
| title | Prevention of catheter-related bacteremia in pediatric intestinal transplantation/short gut syndrome children with long-term central venous catheters |
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