Reorganization of nutritional therapy can markedly reduce the rate of catheter-related blood stream infections in pediatric patients receiving parenteral nutrition - a 7-year prospective follow-up study.
BACKGROUND
Implementation of hygienic measures and simple changes in the structure of medical team may considerably reduce the rate of catheter-related bloodstream infections (CRBSIs) in parenterally nourished patients.


OBJECTIVE
To analyze the effects of organizational changes in parenteral nutrition services on the CRBSI rates in pediatric patients.


METHODS
We compared the CRBSI rates documented prior to, during and after the implementation of the organizational changes (introduction of a nutritional support team and related procedures, medical staff training).


RESULTS
A total of 260 courses of parenteral nutrition were offered to 141 pediatric patients during the analyzed period. Thirty CRBSIs were documented during this period. The most frequent etiological factors were staphylococci (21/30), followed by Klebsiella pneumoniae, Escherichia coli and Candida albicans (2/30 each). The reorganization was reflected by more than 8-fold reduction of the CRBSI incidence rate: from the initial value of 10.14 to 6.89 per 1000 catheter days and 1.17 per 1000 catheter days during and after the reorganization, respectively.


CONCLUSIONS
Introduction of a nutritional support team, accompanied by extensive training of medical staff, can result in a marked reduction of CRBSI rate in pediatric patients nourished parenterally in a hospital setting.
Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk.. aga1@gumed.edu.pl.
Agnieszka
A
Szlagatys-Sidorkiewicz
Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk.. aga1@gumed.edu.pl.
Anna
A
Borkowska
Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk.. aga1@gumed.edu.pl.
Agnieszka
A
Jankowska
Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk.. aga1@gumed.edu.pl.
Mariusz
M
Sroka
Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk.. aga1@gumed.edu.pl.
Maciej
M
Zagierski
Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk.. aga1@gumed.edu.pl.
Anna
A
Gosk
Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk.. aga1@gumed.edu.pl.
Magdalena
M
Słomińska-Frączek
Copernicus PL, Gdansk.. aga1@gumed.edu.pl.
Grzegorz
G
Bogowski
Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk.. aga1@gumed.edu.pl.
Katarzyna
K
Plata-Nazar
Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk.. aga1@gumed.edu.pl.
Katarzyna
K
Sznurkowska
Institute of Mathematics, University of Gdansk. Poland.. aga1@gumed.edu.pl.
Grzegorz
G
Krzykowski
Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk.. aga1@gumed.edu.pl.
Barbara
B
Kamińska
D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007223:Infant; D017053:Infection Control / Q000379:methods*; D008297:Male; D010288:Parenteral Nutrition; D011446:Prospective Studies; D012107:Research Design; D012308:Risk Management