[Infections of central venous catheters in home parenteral nutrition: a retrospective monocentric study over 2 years].
OBJECTIVE
Infection of the central venous catheter (CVC) is the main aggravating factor of parenteral nutrition. The aim of this study was to determine the ecology of these infections in our home parenteral nutrition center and to evaluate our care protocol.


METHODS
The present study was monocentric and retrospective, and was conducted in the parenteral nutrition service of the Marseille University Hospital between 1 January 2011 and 31 May 2012. During this period, all the children who presented fever and a positive hemoculture in a medical emergency were taken into account, and the characteristics of the infection were analyzed.


RESULTS
After 17 months, 17 children had been subject to an infection in their central catheter: 47 bacteremia were identified, which is equivalent to 5.4 infections for 1000 days of CVC. An average 2.8 hemocultures were performed during this time. The most common bacterium was Staphylococcus hominis. The children affected by a digestive stoma or by a gastrostomy were not subject to more infections and their ecology was not different. All the children were referred to the hospital and treated with an intravenous antibiotic through the CVC.


CONCLUSIONS
As expected during the time of the study, the infection rate was very high. This finding led us to reassess our prevention protocol. It is also very likely that the number of infections was overestimated due to the protocol for sampling in the hemocultures and their subsequent analysis. Lastly, some children relapsed easily, although no predisposing factor was found in the present study. The therapy chosen was in agreement with the best practices and the ecology recovered.


CONCLUSIONS
The high number of infections observed during the study encourages a prospective evaluation of current practices.
Service de pédiatrie multidisciplinaire, hôpital d'enfants de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France. Electronic address: emilie.moreau@ap-hm.fr.
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Moreau
Unité de médecine infantile, hôpital d'enfants de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
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Bresson
Unité de médecine infantile, hôpital d'enfants de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
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Bosdure
Service de pédiatrie multidisciplinaire, hôpital d'enfants de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
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Sarles
Service de pédiatrie multidisciplinaire, hôpital d'enfants de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
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Coste
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008297:Male; D016331:Parenteral Nutrition, Home; D012189:Retrospective Studies; D055815:Young Adult
D000900:Anti-Bacterial Agents