[Sepsis due to multiple-lumen catheters in bone marrow transplantation with total parenteral nutrition. The effect of the type of isolation].
The use of catheters for total parenteral nutrition frequently leads to infectious complications which are more common and virulent in patients with marrow aplasia. The main purpose of this paper was to evaluate the influence in the development of catheter-induced sepsis of the place where it was introduced (in the theatre or hospitalization unit), the type of isolation (laminar flux unit or conventional room), and its relation to the period of isolation and of the total parenteral nutrition. Forty-one bone-marrow transplant patients were studied, 18 of them autologous and 23 allogenic, who were administered total parenteral nutrition with a two-way central venous polyurethane catheter. Of the 41 catheters applied, 16 were introduced in the operating theater and 25 in the hospitalization unit: of these, 7 and 11 respectively were infected. Isolation was as follows: 21 in standard rooms and 20 in a laminar flux unit, with 11 and 7 infections respectively. We believe that the lower level of infections in laminar flux isolation was not significant, this being a reduced number of case studies. The duration of the catheter and total parenteral nutrition for the 18 patients with sepsis was 36.5 +/- 15.1 and 23.7 +/- 8.4 days respectively: this was greater--albeit possibly not significantly so because of the special characteristics of these patients--than the 29.1 +/- 12.9 and 19.5 +/- 10.9 days for non-septic cases. This reveals a catheter sepsis rate of 43.9%, in 88% of cases caused by skin flora micro-organisms (66.6% coagulase-negative staphylococcus).(ABSTRACT TRUNCATED AT 250 WORDS)
Olóriz
M R
MR
Unidad de Nutrición, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria.
Gándara
M J
MJ
Bárcena
M J
MJ
Varela
M R
MR
Fuente
E
E
D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D016026:Bone Marrow Transplantation; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data; D004780:Environment, Controlled; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010289:Parenteral Nutrition, Total / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data; D010356:Patient Isolation / Q000379:methods*; D013997:Time Factors