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.
Keywords
infection - bacterial translocation - neonatal intestinal obstruction - necrotising
enterocolitis - gastroschisis
