Eur J Pediatr Surg 2012; 22(01): 050-053
DOI: 10.1055/s-0031-1287853
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Septicaemia Due to Enteric Organisms is a Later Event in Surgical Infants Requiring Parenteral Nutrition

M. Bishay
1  UCL Institute of Child Health, Department of Paediatric Surgery, London, United Kingdom
,
G. Retrosi
1  UCL Institute of Child Health, Department of Paediatric Surgery, London, United Kingdom
,
V. Horn
2  Great Ormond Street Hospital for Children, Pharmacy Department, London, United Kingdom
,
E. Cloutman-Green
3  Great Ormond Street Hospital for Children, Microbiology Department, London, United Kingdom
,
K. Harris
3  Great Ormond Street Hospital for Children, Microbiology Department, London, United Kingdom
,
P. de Coppi
1  UCL Institute of Child Health, Department of Paediatric Surgery, London, United Kingdom
,
N. Klein
1  UCL Institute of Child Health, Department of Paediatric Surgery, London, United Kingdom
,
S. Eaton
1  UCL Institute of Child Health, Department of Paediatric Surgery, London, United Kingdom
,
A. Pierro
1  UCL Institute of Child Health, Department of Paediatric Surgery, London, United Kingdom
› Author Affiliations
Further Information

Publication History

14 May 2011

22 August 2011

Publication Date:
23 January 2012 (online)

Abstract

Introduction The purpose of this study was to determine whether, in surgical infants requiring parenteral nutrition (PN), septicaemia due to enterococci or Gram-negative bacilli occurs later than septicaemia due to coagulase-negative staphylococci (CNS).

Patients/Material and Methods We retrospectively studied 112 consecutive surgical infants (corrected gestational age up to 3 months) receiving PN for at least 5 days for congenital or acquired intestinal anomalies over a 2-year period (July 2007–June 2009). Data collected included diagnosis, duration of PN, episodes of septicaemia (defined as growth of bacteria from blood culture), and organisms cultured. We compared the time to first occurrence of septicaemia due to CNS with the times to first occurrence of septicaemia due to enterococci, Gram-negative bacilli, or other micro-organisms, using Kruskal-Wallis nonparametric ANOVA test and Dunn’s multiple comparisons test. Data are given as median (range).

Results 31 patients (28%) had a total of 65 episodes of septicaemia. Septicaemia due to CNS was most common, occurring in 22% of patients, after 17 days (1–239) of PN. Septicaemia due to enteric organisms was less common and occurred significantly later, at 59 (24–103) days for enterococci (p<0.01), and at 55 (30–106) days for Gram-negative bacilli (p<0.05).

Conclusions Septicaemia due to enterococci or Gram-negative bacilli occurs later in the course of PN than septicaemia due to CNS, in surgical infants. This suggests that these infants become more vulnerable to the translocation of enteric micro-organisms after a longer period of parenteral nutrition.