Avtor/Urednik		Pogorelc-Erjavec, Andreja; Derganc, Metka; Grosek, Štefan
Naslov		Okužbe Broviakovih katetrov za dolgotrajno parenteralno prehrano pri otrocih s sindromom kratkega črevesa
Prevedeni naslov		Infection of Broviac central venous catheters used for long term parenteral nutrition in children with short bowel syndrome
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 41, št. Suppl 2
Leto izdaje		2002
Obseg		str. 95-102
Jezik		slo
Abstrakt		The paper is a report on infections of Broviac central venous catheters for parenteral nutrition in five children with short bowel syndrome who were treated from 1994 to 2001. Since 1996, four children have been included in our home care program and one of them no longer requires parenteral nutrition after bowel transplantation. The average duration of parenteral nutrition per child was 1391 days, with a mean of 4.8 catheters per child. There were a total of 60 episodes of clinically suspected sepsis thought to be related to the catheter. Blood cultures were positive in 19 (32%) cases. Local infection around the catheter was found in 7 cases. The isolated organisms included gram-positive bacteria (mostly coagulase negative and positive staphylococci) in 63% of cases, gram-negative bacteria in 16% of cases and fungi in 21% of cases. Because of unsuccessful antibiotic treatment of bacterial sepsis, the catheter had to be removed in 26% of episodes. In addition, it was also removed in all cases of fungal sepsis. In 43% of local infections, the catheter was removed due to unsuccessful antibiotic treatment None of the children died because of infection.
Izvleček		Poročamo o okužbah pri uporabi Broviakovih osrednjih venskih katetrov za parenteralno prehrano pri petih otrocih s sindromom kratkega črevesa, v letih 1994-2001. Od leta 1996 so štirje v domači oskrbi, eden od otrok pa parenteralne prehrane, po presaditvi črevesa, ne potrebuje več. Povprečno trajanje parenteralne prehrane na enega otroka je bilo 1.391 dni, povprečno je imel vsak otrok 4,8 katetra. Skupaj so imeli otroci 60 vročinskih epizod, ob katerih smo 19-krat (32 %) iz krvi osamili bakterijo. Sedemkrat so imeli otroci celulitis ob izstopu katetra iz podkožja. Po Gramu pozitivne bakterije smo iz krvne kulture osamili v 12 od 19 primerov (63 %) (najpogosteje stafilokoke s koagulazo ali brez nje), v 3 od 19 primerov (16 %) smo osamili po Gramu negativne bakterije in glive v 4 od 19 primerov (21 %). Zaradi neuspešnega antibiotičnega zdravljenja bakterijske okužbe smo kateter odstranili v 26 %. Glivične okužbe nismo nikoli zdravili brez odstranitve katetra - kateter smo zaradi tega razloga odstranili v 21 % vseh seps. Zaradi neuspešnega antibiotičnega zdravljenja celulitisa ob katetru smo kateter odstranili pri 43 % teh okužb. Nobeden od otrok zaradi okužbe ni umrl.
Deskriptorji		SHORT BOWEL SYNDROME PARENTERAL NUTRITION CATHETERIZATION, CENTRAL VENOUS SEPSIS CHILD