P1.47: Evaluation of central venous catheters in hospitalized pediatric patients with intestinal failure from a brazilian gastroenterology reference center

Abstract

Introduction: Intestinal Failure (IF) is a debilitating condition, defined as the need for parenteral Nutrition (PN) for more than 60 days. One of the most important IF complication is central catheter-associated bloodstream infection (CCABSI). The Taurolidine line prophylaxis seems to be a promising measure for the prevention of these infections. Materials and Methods: retrospective study, evaluating 89 catheters used by 18 pediatric patients with IF from 2015 to 2017 at a center in the Southern Brazil. Results and Discussion: Most patients (61%) had short bowel syndrome, and prevalence of CCABSI was higher in this group of patients (P=0,036). Of the 18 children studied, 14 (77,8%) had at least one CCABSI. A total of 89 catheters were used by these children – mean of 4,95/patient. CCABSI occurred in 27 catheters (30,3%). 66.3% of the total number of catheters were non-tunneled and 32,6% were tunneled. 35,6% of the non-tunneled CVC had CCABSI compared to 20,7% of the tunneled (p=0,289).34,8% of the catheters were removed due to mechanical problems and 18% were removed due to CCABSI. The frequency of CCABSI was 5.7 per 1000 catheter days. The taurolock line prophylaxis has been used in our hospital since march/2016 and this paper included patients before this period. We found a statistically significant association between CCABSI and death (p=0,01). Patients with at least one CCABSI needed to change the CVC more often (x= 4 catheters) than children that did not presented infection (x= 2 catheters) (p=0,035). The use of taurolock improved catheter survival from 20 days to 26 days (p=0,032). Conclusions: CCABSIs was the main cause of death in this group of patients and frequency of CCABSIs is still high among our population. The use of taurolock helped to increase the days that the CVC remained in the patient, but more data is necessary to correlate this lock with an improvement in infection rate in our population.