Central venous catheter related bloodstream infections in adult patients on home parenteral nutrition: Prevalence, predictive factors, therapeutic outcome

Santarpia, Lidia; Buonomo, Antonio Riccardo; Pagano, Maria Carmen; Alfonsi, L.; Foggia, Maria; Mottola, Michele; Marinosci, Geremia Zito; Contaldo, Franco; Pasanisi, Fabrizio

doi:10.1016/j.clnu.2016.03.009

Cited by 62 publications

(48 citation statements)

References 31 publications

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“…The epidemiology of CRBSIs in our study is consistent with available literature, with coagulase negative staphylococci and Staphylococcus aureus the most common gram‐positive organisms and Klebsiella species the most common gram‐negative organisms. Like data reported in other pediatric studies, the most common presenting symptom in the setting of CRBSIs was fever (82%), although gastrointestinal symptoms (42%) and symptoms of upper respiratory infections (21%) were also prominent.…”

Section: Discussionsupporting

confidence: 89%

“…Multiple studies have focused on the epidemiology of and risk factors for CRBSIs in the home PN population, the majority of which have been performed in adult patients. Risk factors for CRBSIs identified in these adult studies, such as male sex, patient age, presence of enterocutaneous stomas, and public insurance, were not found to be associated with CRBSIs in our cohort of patients. Nor were risk factors identified in the pediatric literature, including public insurance, younger age, higher PN infusion frequency, double lumen central lines, and short bowel syndrome, found to be associated with CRBSIs in our study.…”

Section: Discussioncontrasting

confidence: 54%

“…CRBSI rates have been reported to vary from as low as 0.35 per 1000 catheter days to as high as 3.1 per 1000 catheter days, likely related to differences in study design and heterogeneous patient cohorts. Risk factors for CRBSIs have included frequency of lipid infusion, male sex, patient age, presence of ulcers, enterocutaneous stomas, public insurance, underlying malignancy, and use of systemic anticoagulants …”

Section: Introductionmentioning

confidence: 99%

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Epidemiology and Risk Factors for Outpatient‐Acquired Catheter‐Related Bloodstream Infections in Children Receiving Home Parenteral Nutrition

Wozniak

Bechtold²,

Reyen

et al. 2018

J Parenter Enteral Nutr

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Epidemiology and Risk Factors for Outpatient‐Acquired Catheter‐Related Bloodstream Infections in Children Receiving Home Parenteral Nutrition

Wozniak

Bechtold²,

Reyen

et al. 2018

J Parenter Enteral Nutr

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show abstract

“…In patients without these symptoms, the decision to remove the CVC becomes more difficult, with some guidelines recommending not removing the CVC in patients with fever and mild to moderate disease 110 . Recent publications have also revealed experience with successful salvage of long‐term CVC catheters in the majority of cases 119 , 120 . Similarly, the decision to provide PN holiday should be made according to clinical status.…”

Section: Pn Complicationsmentioning

confidence: 99%

Management of Parenteral Nutrition in Hospitalized Adult Patients

Mundi

Nystrom

Hurley

et al. 2016

J Parenter Enteral Nutr

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Despite the high prevalence of malnutrition in adult hospitalized patients, surveys continue to report that many clinicians are undertrained in clinical nutrition, making targeted nutrition education for clinicians essential for best patient care. Clinical practice models also continue to evolve, with more disciplines prescribing parenteral nutrition (PN) or managing the cases of patients who are receiving it, further adding to the need for proficiency in general PN skills. This tutorial focuses on the daily management of adult hospitalized patients already receiving PN and reviews the following topics: (1) PN basics, including the determination of energy and volume requirements; (2) PN macronutrient content (protein, dextrose, and intravenous fat emulsion); (3) PN micronutrient content (electrolytes, minerals, vitamins, and trace elements); (4) alteration of PN for special situations, such as obesity, hyperglycemia, hypertriglyceridemia, refeeding, and hepatic/renal disease; (5) daily monitoring and adjustment of PN formula; and (6) PN-related complications (PN-associated liver disease and catheter-related complications).

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“…16 This risk did not remain significant in the multivariable regression analysis when we adjusted for comorbidities, including current malignancy, chronic inflammatory bowel disease, receipt of any immunosuppressant, and neutropenia. A study examining a pediatric oncology cohort found that the absolute number of outpatient CLABSIs was about twice the number of inpatient CLABSIs in the same period of time.…”

Section: Discussionmentioning

confidence: 88%

Medically Attended Catheter Complications Are Common in Patients With Outpatient Central Venous Catheters

Spires

Rebeiro

Miller³

et al. 2018

Infect. Control Hosp. Epidemiol.

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OBJECTIVE Outpatient central venous catheters (CVCs) are being used more frequently; however, data describing mechanical complications and central-line-associated bloodstream infections (CLABSI) in the outpatient setting are limited. We performed a retrospective observational cohort study to understand the burden of these complications to elucidate their impact on the healthcare system. METHODS Data were retrospectively collected on patients discharged from Vanderbilt University Medical Center with a CVC in place and admitted into the care of Vanderbilt Home Care Services. Risk factors for medically attended catheter-associated complications (CACs) and outpatient CLABSIs were analyzed. RESULTS A CAC developed in 143 patients (21.9%), for a total of 165 discrete CAC events. Among these, 76 (46%) required at least 1 visit to the emergency department or an inpatient admission, while the remaining 89 (54%) required an outpatient clinic visit. The risk for developing a CAC was significantly increased in female patients, patients with a CVC with >1 lumen, and patients receiving total parenteral nutrition. The absolute number of CLABSIs identified in the study population was small at 16, or 2.4% of the total cohort. CONCLUSIONS Medically attended catheter complications were common among outpatients discharged with a CVC, and reduction of these events should be the focus of outpatient quality improvement programs. Infect Control Hosp Epidemiol 2018;39:439-444.

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Central venous catheter related bloodstream infections in adult patients on home parenteral nutrition: Prevalence, predictive factors, therapeutic outcome

Cited by 62 publications

References 31 publications

Epidemiology and Risk Factors for Outpatient‐Acquired Catheter‐Related Bloodstream Infections in Children Receiving Home Parenteral Nutrition

Epidemiology and Risk Factors for Outpatient‐Acquired Catheter‐Related Bloodstream Infections in Children Receiving Home Parenteral Nutrition

Management of Parenteral Nutrition in Hospitalized Adult Patients

Medically Attended Catheter Complications Are Common in Patients With Outpatient Central Venous Catheters

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