Central venous catheter-related infections in children on long-term home parenteral nutrition: incidence and risk factors

Abstract

Background and aims: This study aimed to assess the incidence and etiology of central venous catheter (CVC) infections in children on home parenteral nutrition (HPN). Methods: 207 CVC-years were studied retrospectively in 47 children on HPN, aged 8.1±5.0 years. Results: 125 CVC were used (means: 2.6 CVC/patient and 21 months utilization/CVC). Half of the hospitalizations (162) were due to proven CVC-related infections. The mean infection incidence was 2.1/1000 HPN days. The total population divided in two groups below and above this value: group one including 24 children, incidence ≤ 2.1 per 1000 days (mean: 0.83) and group two including 23 children, incidence >2.1 per 1000 days (mean: 4.3). No differences were found between the two groups in terms of underlying disease, presence of ostomies, age at the time of HPN onset, or micro-organisms responsible. The only differences (p<0.05) were the mean duration of HPN (longer in group one) and the delay between HPN onset and the first infection (longer in group one). Conclusions: This study does not highlight any risk factors for CVC infection. However, early CVC infections after HPN onset appear to predict a bad prognosis.