Microbial Translocation in Neonates and Infants Receiving Long-term Parenteral Nutrition

摘要: Objective: To explore whether episodes of endogenous septicemias due to microbial translocation are clinically relevant in neonates and infants who receiving long-term parenteral nutrition (PN). Design: Prospective observational cohort study 2 years. Setting: Neonates underwent surgical procedures required PN because gastrointestinal abnormalities. Measurements: Surveillance cultures the oropharynx gut were obtained at start thereafter twice each week. These processed for all microorganisms, except coagulase-negative staphylococci, a semiquantitative manner detect overgrowth. A blood sample was taken culture from both central venous line peripheral vein on clinical indication only. Microbial diagnosed when microorganisms that isolated also carried throat and/or rectum within weeks preceding episode septicemia. Main Results: Of 94 infants, 10 (11%) experienced 24 septicemia (ie, 7.3 septicemic per 1000 days PN). Six 15 enteric includingEscherichia coli, Klebsiella, Candidaspecies, enterococci. occurred after median 58 (range, 32 286 days). The organisms caused always present high concentrations (>105colony-forming units gram [ie, overgrowth]) 60% episodes. All but one with an abnormal serum bilirubin level (>17 μmol/L [0.99 mg/dL]). Conclusion: In PN, may be gut-related phenomenon. (Arch Surg. 1996;131:176-179)