Background: Central line-associated bloodstream infection (CLABSI) is a potentially life-threatening complication in home parenteral nutrition (HPN) patients. We investigated potential predictors of CLABSI in a cohort of adult HPN patients Methods: Patients managed by the HPN service at the Hospital of University of Pennsylvania on January 1, 2018, were included and followed through June 30, 2019, using existing medical records to collect demographic and clinical data. CLABSIs were adjudicated prospectively by infectious disease experts. Variables with P ≤ .2, when comparing patients with CLABSIs and those without, were included in logistic regression models. Results: Among 114 patients, mean age was 54 ± 16 years, 78/114 were female, and BMI was 25 ± 5.6. Median experience with HPN was 516 days (range, 15-10,281), and 30 had prior CLABSI. Catheter types were peripherally inserted central catheters (83/114), tunneled (27), and implanted (4). The incidence of CLABSI was 0.89 per 1000 catheter days. One multivariate model identified ostomy/wound (odds ratio [OR], 22.0; 95% CI, 4.8-101.7), tunneled/implanted catheter (OR, 4.4; 95% CI, 1.4-13.9), and BMI < 18.5 (OR, 5.9; 95% CI, 1.4-24.2) as predictors of CLABSI. A second model identified patients with 2 potential predictors (OR, 22.9; 95% CI, 5.6-93.5) and tunneled/implanted catheter (OR, 6.7; 95% CI, 2.1-21.8) at high risk of CLABSI. Whether CLABSIrates might be reduced by more intense training in wound or catheter care (especially for those with multiple predictors), different types of catheters, or rapid treatment of malnutrition will require further study.

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This year, 2018, marks the 20th year that the Centers for Disease Control and Prevention (CDC) has supported the United States National Comprehensive Cancer Control Program (NCCCP). The NCCCP emerged from a movement called comprehensive cancer control (CCC), which began as a concept in 1994 and is focused on addressing cancer in a comprehensive manner, across the continuum of cancer control rather than focusing in on one cancer site (e.g., colorectal) or only on one aspect of care delivery (e.g., prevention). CCC is an approach that brings together multi-sector partners to collectively address the cancer burden in a community by leveraging existing resources and identifying and addressing cancer-related issues and needs. In 1999, the Comprehensive Cancer Control National Partnership (CCCNP) was officially formed, bringing together key federal and national cancer stakeholders to support the NCCCP and their CCC coalitions as they develop and implement CCC plans. This is the third Special Issue on CCC, all published in Cancer Causes and Control. In this Special Issue, we offer reflections on the progress made over the past 20 years in addressing the US cancer burden through the CCC approach and present a range of topics, from a description of how CCC programs and coalitions have evolved over the years to analyses of how they can affect change through policy,

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