title: Septicaemia due to enteric organisms is a later event in surgical infants requiring parenteral nutrition.
abstract: BACKGROUND
  The purpose of this study was to determine whether, in surgical infants requiring parenteral nutrition (PN), septicaemia due to enterococci or Gram-negative bacilli occurs later than septicaemia due to coagulase-negative staphylococci (CNS).
  
  
  METHODS
  We retrospectively studied 112 consecutive surgical infants (corrected gestational age up to 3 months) receiving PN for at least 5 days for congenital or acquired intestinal anomalies over a 2-year period (July 2007-June 2009). Data collected included diagnosis, duration of PN, episodes of septicaemia (defined as growth of bacteria from blood culture), and organisms cultured. We compared the time to first occurrence of septicaemia due to CNS with the times to first occurrence of septicaemia due to enterococci, Gram-negative bacilli, or other micro-organisms, using Kruskal-Wallis nonparametric ANOVA test and Dunn's multiple comparisons test. Data are given as median (range).
  
  
  RESULTS
  31 patients (28%) had a total of 65 episodes of septicaemia. Septicaemia due to CNS was most common, occurring in 22% of patients, after 17 days (1-239) of PN. Septicaemia due to enteric organisms was less common and occurred significantly later, at 59 (24-103) days for enterococci (p<0.01), and at 55 (30-106) days for Gram-negative bacilli (p<0.05).
  
  
  CONCLUSIONS
  Septicaemia due to enterococci or Gram-negative bacilli occurs later in the course of PN than septicaemia due to CNS, in surgical infants. This suggests that these infants become more vulnerable to the translocation of enteric micro-organisms after a longer period of parenteral nutrition.
authors.affiliation: UCL Institute of Child Health, Department of Paediatric Surgery, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Bishay
authors.forename: G
authors.initials: G
authors.lastname: Retrosi
authors.forename: V
authors.initials: V
authors.lastname: Horn
authors.forename: E
authors.initials: E
authors.lastname: Cloutman-Green
authors.forename: K
authors.initials: K
authors.lastname: Harris
authors.forename: P
authors.initials: P
authors.lastname: de Coppi
authors.forename: N
authors.initials: N
authors.lastname: Klein
authors.forename: S
authors.initials: S
authors.lastname: Eaton
authors.forename: A
authors.initials: A
authors.lastname: Pierro
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy*; D018988:Bacterial Translocation; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D016983:Enterococcus / Q000302:isolation & purification / Q000502:physiology; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D005260:Female; D020139:Gastroschisis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D006090:Gram-Negative Bacteria / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy*; D007422:Intestines / Q000382:microbiology*; D008297:Male; D010288:Parenteral Nutrition; D012189:Retrospective Studies; D013210:Staphylococcus / Q000302:isolation & purification / Q000502:physiology