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| 1 | Central line-associated bloodstream infection among children with biliary atresia listed for liver transplantation显示文摘BACKGROUND Pre-transplant nutrition is a key driver of outcomes following liver transplantation in children.Patients with biliary atresia(BA) may have difficulty achieving satisfactory weight gain with enteral nutrition alone,and parenteral nutrition(PN) may be indicated.While PN has been shown to improve anthropometric parameters of children with BA listed for liver transplantation,less is known about the risks,particularly infectious,associated with this therapy among this specific group of patients.AIM To describe the incidence,microbiology,and risk factors of central line-associated bloodstream infection(CLABSI) among children with BA listed for liver transplantation.METHODS Retrospective review of children aged ≤ 2-years of age with BA who were listed for primary liver transplantation at Texas Children's Hospital from 2008 through2015(n = 96).Patients with a central line for administration of PN(n = 63) were identified and details of each CLABSI event were abstracted.We compared the group of patients who experienced CLABSI to the group who did not,to determine whether demographic,clinical,or laboratory factors correlated with development of CLABSI.RESULTS Nineteen of 63 patients(30%,95%CI:19,43) experienced 29 episodes of CLABSI during 4800 line days(6.04 CLABSI per 1000 line days).CLABSI was predominantly associated with Gram-negative organisms(14/29 episodes,48%)including Klebsiella spp.,Enterobacter spp.,and Escherichia coli.The sole polymicrobial infection grew Enterobacter cloacae and Klebsiella pneumoniae.Grampositive organisms(all Staphylococcus spp.) and fungus(all Candida spp.)comprised 9/29(31%) and 6/29(21%) episodes,respectively.No demographic,clinical,or laboratory factors were significantly associated with an increased risk for the first CLABSI event in Cox proportional hazards regression analysis CONCLUSION There is substantial risk for CLABSI among children with BA listed for liver transplantation.No clinical,demographic,or laboratory factor we tested emerged as an independent predictor of CLABSI.While our data did not show an impact of CLABSI on the short-term clinical outcome,it would seem prudent to implement CLABSI reduction strategies in this population to the extent that each CLABSI event represents potentially preventable hospitalization,unnecessary healthcare dollar expenditures,and may exact an opportunity cost,in terms of missed allograft offers. | Nicole D Triggs Stacey Beer Sonam Mokha Kat Hosek Danielle Guffey Charles G Minard Flor M Munoz Ryan W Himes | 2019 | World Journal of Hepatology2019，11，2： | 2 |
| 2 | Nutritional support and infection: Does the route matter显示文摘 | Minard G Kudsk KA | 1998 | World J Surg1998，22，2： | 1 |
| 3 | Is early feeding beneficial? How early is early?显示文摘 | MINARD G KUDSK K A | 1994 | New Horiz1994，2，： | 1 |
| 4 | Use of high resolution 13C-NMR to examine the enzymatic covalent binding of 13C-labeled 2,4-dichlorophenol to humic substances 显示文摘 | HATCHER P G BORTIAYNSKI J M MINARD R D | 1993 | Environmental Science & Technology1993，27，10： | 1 |
| 5 | Lowserum total calcium concentration as a marker of low serum ionizedcalcium concentration in critically ill patients receiving specializednutrition support显示文摘 | Dickerson RN Henry NY Miller PL Minard G Brown RO | 2007 | Nutr Clin Pract2007，22，3： | 1 |
| 6 | Is early feeding benefices?How early is early?显示文摘 | Kudsk KA | 1994 | New Horiz1994，2，2： | 1 |
| 7 | The guanine nucleotide exchange factor Tiam1 increases colon carcinoma growth at metastatic sites in an orthotopic nude mouse model显示文摘 | Minard M E Herynk M H Collard J G | 2005 | Oncogene2005，24，15： | 1 |
| 8 | Is eary teeding beneficical howearly is earlyu new hori 显示文摘 | Minard G kudsk KA | 1994 | 2(2) :156-1631994，2，2： | 1 |
| 9 | Is early feeding beneficial? How early is early? 显示文摘 | Minard G Kudsk KA | 1994 | New Horiz1994，2，2： | 1 |
| 10 | Nutritional support and infection: does the route matter显示文摘 | Minard G KtldskKA | 1998 | World J Surg1998，22，： | 1 |
| 11 | Is early feeding beneficial? How early is early? 显示文摘 | Minard G Kudsk KA | 1994 | New Horiz1994，2，2： | 1 |
| 12 | Sources of NADPH and expression of mammalian NADP^+-specific isocitrate dehydrogenases in Saccharomyces cerevisiae显示文摘 | Minard K I Jermings G T Loftus T M | 1998 | Journal of Biological Chemistry1998，273，31： | 1 |
| 13 | Tiam 1 regulates cell adhe-sion,migration and apoptosis in colon tumor cells显示文摘 | Minard M E Ellis L M Gallick G E | 2006 | Clin Exp Metasta-sis2006，23，56： | 1 |
| 14 | Is early feeding beneficial? How early is early? 显示文摘 | Minard G Kudsk KA | 1994 | New Horiz1994，2，2： | 1 |
| 15 | Accuracy of methods to estimate ionized and'corrected' serum calcium concentrations in critically ill multiple trauma patients receiving specialized nutrition support显示文摘 | DICKERSON RN ALEXANDER KH MINARD G | 2004 | JPEN J Parenter Enteral Nutr2004，28，3： | 1 |
| 16 | Nutritional support and infection:does the route matter显示文摘 | Minard G Kudsk KA | 1998 | World J Surg1998，22，2： | 1 |
| 17 | The guanine nucleotide exchange factor Tiam1 increases colon carcinoma growthat metastatic sites in an orthotopic nude mouse model显示文摘 | Minard M E Herynk M H Collard J G | | 0，，15： | 1 |
| 18 | 3D MRI of non-Gaussian ^3He gas diffusion in the rat lung显示文摘 | Jacob RE Laicher G Minard KR | 2007 | Minard Journal of Magnetic Resonance2007，188，2： | 1 |
| 19 | Remote control of insulin secretion by fat cells in Drosophila显示文摘 | Gé minard C Rulifson EJ Lé opold P | 2009 | Cell Metabolism2009，10，3： | 1 |
| 20 | Tiaml regulates cell adhesion,migration and apoptosis in colon tumor cells显示文摘 | Minard M E Ellis L M Gallick G E | 2006 | Clin Exp Metastasis2006，23，56： | 1 |
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