BACKGROUND: Catheter-related bloodstream infections are a serious and common complication in patients receiving home parenteral nutrition (HPN). METHODS: Prevalence of infections, type of agents, and effectiveness of antibiotic therapy were evaluated in 296 patients (133 males, 163 females; mean age 58.2 +/- 13.5 years) receiving HPN for at least 3 months, from January 1995 to December 2006. Patients underwent 99,969 (331 +/- 552; minimum 91, maximum 4353) days of catheterization, corresponding to 93,236 (311 +/- 489; minimum 52, maximum 4353) days of HPN. RESULTS: Fifty-two patients (24 males and 28 females; 35 oncological and 17 nononcological) were diagnosed with 169 infections. The overall corresponding infection rate was 2.0 per 1000 days of catheterization, with a progressive, regular decrease with time. In 30 cases, immediate central venous catheter removal was necessary. Infections were eradicated in 103 of 139 (74%) cases. As to the most common causative agent, 86 (51%) infections were due to Staphylococcus epidermidis. Of these, 64 were treated from 1995 to 2004, 57 of them (89%) successfully; 22 were treated from 2005 onward, only 7 of them (32%) successfully. CONCLUSIONS: Although the global infection rate has progressively decreased over the years, S epidermidis has shown an alarming increase in resistance to antibiotic treatment in the last 2 years, suggesting the need for strategies to prevent central venous catheter infection.
BACKGROUND: Catheter-related bloodstream infections are a serious and common complication in patients receiving home parenteral nutrition (HPN). METHODS: Prevalence of infections, type of agents, and effectiveness of antibiotic therapy were evaluated in 296 patients (133 males, 163 females; mean age 58.2 +/- 13.5 years) receiving HPN for at least 3 months, from January 1995 to December 2006. Patients underwent 99,969 (331 +/- 552; minimum 91, maximum 4353) days of catheterization, corresponding to 93,236 (311 +/- 489; minimum 52, maximum 4353) days of HPN. RESULTS: Fifty-two patients (24 males and 28 females; 35 oncological and 17 nononcological) were diagnosed with 169 infections. The overall corresponding infection rate was 2.0 per 1000 days of catheterization, with a progressive, regular decrease with time. In 30 cases, immediate central venous catheter removal was necessary. Infections were eradicated in 103 of 139 (74%) cases. As to the most common causative agent, 86 (51%) infections were due to Staphylococcus epidermidis. Of these, 64 were treated from 1995 to 2004, 57 of them (89%) successfully; 22 were treated from 2005 onward, only 7 of them (32%) successfully. CONCLUSIONS: Although the global infection rate has progressively decreased over the years, S epidermidis has shown an alarming increase in resistance to antibiotic treatment in the last 2 years, suggesting the need for strategies to prevent central venous catheter infection.
Authors: Sara C Keller; Deborah Williams; Mitra Gavgani; David Hirsch; John Adamovich; Dawn Hohl; Amanda Krosche; Sara Cosgrove; Trish M Perl Journal: Infect Control Hosp Epidemiol Date: 2016-10-04 Impact factor: 3.254
Authors: Vivian M Zhao; Daniel P Griffith; Henry M Blumberg; Nisha J Dave; Cynthia H Battey; Therese A McNally; Kirk A Easley; John R Galloway; Thomas R Ziegler Journal: Nutrition Date: 2012-08-02 Impact factor: 4.008
Authors: Y Wouters; M Theilla; P Singer; S Tribler; P B Jeppesen; L Pironi; L Vinter-Jensen; H H Rasmussen; F Rahman; G J A Wanten Journal: Aliment Pharmacol Ther Date: 2018-07-05 Impact factor: 8.171
Authors: Lidia Santarpia; Giulio Viceconte; Maria Foggia; Lucia Alfonsi; Grazia Tosone; Luigi Camera; Maria Carmen Pagano; Giuseppe De Simone; Franco Contaldo; Fabrizio Pasanisi Journal: Nutrients Date: 2019-03-09 Impact factor: 5.717