Introduction: Currently the best outcome for chronic intestinal failure (IF) is achieved by discharging children home after parent/carer(s) have undergone a formal training programme to connect and disconnect PN infusions from the child’s central venous catheter (CVC). Catheter related bloodstream infections (CRBSI) are the most common potentially life-threatening complication. The aim of this study was to prospectively compare the incidence of CRBSI in short bowel syndrome (SBS) with IF related to other aetiologies in children at home with care by parent(s).

Methods: A prospective record was kept of blood culture results from all children managed by our IF rehabilitation service over a 4-year period from January 2015-January 2019. CRBSI was diagnosed when a child presented with significant fever and/or other symptoms suggestive of septicaemia and blood culture from the central venous catheter (CVC) was positive (in the absence of other focus of infection). The total number of children on long-term PN at home, the number with short bowel syndrome (SBS) and the number of CRBSI in each group were calculated.

Results: A total of 67 children(31 male, 36 female) aged from 6 months to 18 years were treated with PN at home. Eighteen cases had SBS (aetiology: volvulus in 7, necrotising enterocolitis in 6, gastroschisis in 2, long segment Hirschprungs in 2 and congenital in 1) . Ten were male and 8 female and aged from 6 months – 18 years. Other children were diagnosed with motility disorder in 27, primary mucosal disease in 14 and IF secondary to a haematological/immunology disorders in 8 cases. There were a total of 38,606 line days with 16,197 line days in SBS and 22409 with other conditions. There were a total of 112 CRBSIs giving an overall infection rate of 2.95/1000 line days. Sixteen infections were in children with SBS, giving an infection rate of 0.98 infections/1000 line days. Non-SBS children had 96 infections in 22409 line days, an infection rate of 4.2/1000 line days. There was a significant difference in infection rate between those with and without SBS p<0.00001.

Conclusion: Children with SBS had a significantly lower incidence of CRBSI than those with IF due to other aetiologies. Factors related to the underlying disease may contribute to the rate of CRBSI. Further studies are needed comparing disease groups in children.