Abstract
Background: Pediatric short bowel syndrome (SBS) is a devastating clinical entity that is usually managed with parenteral nutrition (PN). Catheter-related bloodstream infection (CRBSI) is a serious complication of long-term PN. The aim of this study was to evaluate the incidence and risk factors of CRBSI in SBS children. Methods: Nineteen pediatric patients with SBS were retrospectively recruited from Shanghai Children’s Hospital between August 2015 and December 2019. Clinical data, including demographics, aetiology of SBS, site and type of catheters, duration of PN, comorbidities, and microbiological data regarding CRBSI, were collected and reviewed to assess the CRBSI incidence and associated risk factors. Results: A total of 57 catheter insertions for PN were administered in 19 SBS children. CRBSI was identified in 11 cases among 6 patients during a total catheter days of 1907. The rate of CRBSI was 5.8 per 1000 catheter days. The common manifestations of the SBS children with CRBSI were fever (6/11, 54.5%), lethargy (5/11, 45.4%), stagnation of weight (7/11, 63.6%), and increment of enterostomy fluid (7/11, 63.6%). Potential risk factors for CRBSI included an absence of ileocecal valve (p=0.046), and long duration of PN (p=0.019). The most common microorganism isolated from the blood cultures was Klebsiella pneumoniae (6/11, 54.55%). Conclusions: The rate of CRBSI was 5.8 per 1000 catheter days, and klebsiella pneumoniae was the most common isolated pathogen of CRBSI in the studied SBS children. An absence of ileocecal valve and long duration of PN were potential risk factors of CRBSI.