How Broad Should Gram-Negative Coverage Be for Febrile Parenteral Nutrition Dependent Short Bowel Syndrome Patients?
J Pediatr Gastroenterol Nutr
; 74(6): 845-849, 2022 06 01.
Article
in En
| MEDLINE
| ID: mdl-35045560
ABSTRACT
ABSTRACT Broader spectrum Gram-negative antibiotics are commonly utilized empirically for central line-associated bloodstream infections (CLABSI) in febrile short bowel syndrome (SBS) patients receiving home parenteral nutrition compared to those used empirically for inpatient-acquired CLABSI. This analysis reports 57 CLABSI in 22 patients with SBS admitted from the community and 78 inpatient-acquired CLABSI in 76 patients over a 5-year period. Proportional Gram-negative CLABSI was similar between the SBS and inpatient-acquired cohorts (43.8% vs42.3%, respectively, Pâ =â0.78). 1.8% and 10.3% (Pâ=â0.125) of Gram-negative CLABSI were non-susceptible to ceftriaxone and 0% and 3.8% (Pâ=â0.52) were non-susceptible to ceftazidime in the SBS and inpatient-acquired cohorts, respectively. In the SBS cohort, home ethanol lock therapy and prior culture results impacted Gramnegative pathogen distribution. Broader empiric Gram-negative coverage for CLABSI among SBS patients compared to inpatients is unnecessary. Third-generation cephalosporins represent appropriate empiric Gramnegative agents for febrile SBS patients presenting from the community to our institution.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Short Bowel Syndrome
/
Catheterization, Central Venous
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Parenteral Nutrition, Home
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Catheter-Related Infections
Type of study:
Etiology_studies
Limits:
Humans
Language:
En
Journal:
J Pediatr Gastroenterol Nutr
Year:
2022
Document type:
Article
Country of publication:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
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UNITED STATES OF AMERICA
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US
/
USA