[Decrease in bacterial translocation in burned children treated with controlled nutritional support].
BACKGROUND
Alteration in epithelial enteric cells are the main cause of bacteria translocation and local and systemic infections. Our aim is to evaluate these infections in burned children treated with enteral nutrition and compare the results with our previous observations. Material and methods. We designed a prospective study including 50 patients (0-14 years) with TBSA > 10% (total body surface area). Bacteriological cultures were performed at their admittance and weekly until the discharge. Nutritional necessities were evaluated using calorimetry. Nutritional support was supplied by nasoduodenal tube at continuous rates.


RESULTS
Three (6%) patients with enteral nutrition (Group 1) showed positive blood cultures (two of them by enteric bacteriae). 14 patients (28%) showed local infections (five by enterococci). We performed a retrospective study in a homogenous group of 44 patients (Group 2), previously treated in our Department without controlling nutrition. We found five (11.3%) positive blood cultures (four by enteric bacteriae) and 22 (50%) local infections (eleven by enteric bacteriae). The improvement of systemic and local infection rates and the decrease in infections caused by enteric bacteriae were statistically significative (p < 0.05).


CONCLUSIONS
A controlled nutritional support is a main cause of the improvement in infection rates and decrease in bacterial translocation in pediatric burned patients.
Rivas
S
S
Dpto. de Cirugía Pediátrica, Hospital Universitario Infantil La Paz, Madrid.
Hernández
F
F
Martínez
L
L
López Gutiérrez
J C
JC
Ros
Z
Z
D000293:Adolescent; D018988:Bacterial Translocation / Q000502:physiology*; D002056:Burns / Q000178:diet therapy* / Q000382:microbiology*; D002151:Calorimetry / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D014946:Wound Infection / Q000382:microbiology*