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J.Jpn. Surg. Soc.. 119(6): 644-651, 2018


Feature topic

CONTROL OF CENTRAL VENOUS CATHETER-RELATED BLOODSTREAM INFECTION IN PATIENTS WITH INTESTINAL FAILURE

Department of Pediatric Surgery, Nara Hospital, Faculty of Medicine, Kindai University, Nara, Japan

Takeo Yonekura, Yuji Morishita

Pediatric patients with intestinal failure (IF) caused by short bowel syndrome, congenital diseases of enteropathies, or severe intestinal motility disorders depend on parenteral nutrition (PN) for survival and normal growth and development. The most common complication of long-term PN is catheter-related bloodstream infection (CRBSI), which can lead to increased morbidity and mortality and results in the need for central venous catheter replacement. Recurrent CRBSIs also contribute to the loss of venous access and IF-associated liver disease in patients with IF. The treatment and prevention of CRBSIs are of the utmost importance in the care and management of patients undergoing long-term PN. Antimicrobial lock therapy, especially ethanol lock therapy (ELT), has been used for the treatment of CRBSI. Prophylactic ELT has also recently been used for the prevention of CRBSIs. The present report addresses therapeutic strategies for CRBSIs in patients with IF receiving long-term PN.


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