Infantile Crohn's disease is one of the risk factors of Catheter-related Blood Stream Infection.
Infantile Crohn's disease is one of the risk factors of Catheter-related Blood Stream Infection.
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婴儿克罗恩病是导管相关血流感染的危险因素之一。
DOI：
10.1111/ped.12304
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Kusunoki M.
中科院分区：
文献类型：
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作者：
Koike Y;Uchida K;Inoue M;Ide S;Hashimoto K;Matsushita K;Otake K;Ohkita Y;Araki T;Kobayashi M;Mohri Y;Kusunoki M.
背景：中心静脉置管被认为是小儿恶性疾病和肠衰竭患者化疗或营养支持的重要生命线。本研究分析了在单个日本中心使用布洛维亚克治疗的患者感染风险。方法2003年1月至2011年10月在儿科病房对244例患者进行Broviac系植入。我们分析了导管相关血流感染（CR - BSI）的风险，包括在Broviac插入时或CR - BSI之前的临床特征，包括基础疾病、败血症史、插入情况、药物使用和实验室数据。结果在研究期间，由于缺少血培养数据，共排除了15个品系的数据。在剩下的189个Broviac品系中，52个品系发生了CR - BSI。在单因素分析中，白血病、婴儿克罗恩病、Broviac植入前的败血症史、存在造口、CR - BSI前使用免疫抑制剂是CR - BSI的危险因素。多因素logistic回归分析显示，婴儿克罗恩病、Broviac植入前败血症史和CR - BSI前使用免疫抑制剂与CR - BSI独立相关（分别为P= 0.015、P= 0.045和P= 0.043）。结论婴儿克罗恩病因其病理状况、所需治疗药物和手术干预而具有CR - BSI的高风险。
BackgroundCentral venous catheterization is recognized as a lifeline that is important for chemotherapy or nutritional support in pediatric patients with malignant disease and intestinal failure. This study analyzed the risk of infection with Broviac line use among these patients at a single Japanese center.MethodsTwo hundred and four Broviac lines were inserted in patients in the pediatric ward from January 2003 to October 2011. We analyzed the risk of catheter‐related bloodstream infection (CR‐BSI) using clinical characteristics including underlying disease, sepsis history, inserted situation, drug use, and laboratory data at the time of Broviac insertion or before CR‐BSI.ResultsDuring the study period, data from a total of 15 lines were excluded because of missing blood culture data. In the remaining 189 Broviac lines, 52 lines developed CR‐BSI. On univariate analysis, leukemia, infantile Crohn's disease, sepsis history before Broviac insertion, existence of a stoma opening, and immunosuppressant use before CR‐BSI were risk factors for CR‐BSI. On multivariate logistic regression analysis infantile Crohn's disease, sepsis history before Broviac insertion, and immunosuppressant use before CR‐BSI were independently associated with CR‐BSI (P= 0.015,P= 0.045, andP= 0.043, respectively).ConclusionsInfantile Crohn's disease carries a high risk for CR‐BSI because of its pathological condition, the therapeutic drugs required, and surgical intervention.