BACKGROUND: Risk factors for development of catheter-related bloodstream infections (CRBSI) were studied in 125 adults and 18 children who received home parenteral nutrition (HPN). METHODS: Medical records from a national home care pharmacy were reviewed for all patients that had HPN infused at least twice weekly for a minimum of two years from January 1, 2006-December 31, 2011. Infection and risk factor data were collected during this time period on all patients although those patients who received HPN for a longer period had data collected since initiation of HPN. RESULTS: In adults, 331 central venous catheters (CVCs) were placed. Total catheter years were 1157. Median CVC dwell time was 730 days. In children, there were 53 CVCs placed. Total catheter years were 113.1. Median CVC dwell time was 515 days. There were 147 CRBSIs (0.13/catheter year;0.35/1000 catheter days). In children there were 33 CRBSIs (0.29/catheter year;0.80/1000 days; P < .001 versus adults). In adults, univariate analysis showed use of subcutaneous infusion ports instead of tunneled catheters (P = .001), multiple lumen catheters (P = .001), increased frequency of lipid emulsion infusion (P = .001), obtaining blood from the CVC (P < 0.001), and infusion of non-PN medications via the CVC (P < .001) were significant risk factors for CRBSI. Increased PN frequency was associated with increased risk of CRBSI (P = .001) in children, but not in adults. Catheter disinfection with povidone-iodine was more effective than isopropyl alcohol alone. There were insufficient patients to evaluate chlorhexidine-containing regimens. CONCLUSION: Numerous risk factors for CRBSI were identified for which simple and current countermeasures already exist.
BACKGROUND: Risk factors for development of catheter-related bloodstream infections (CRBSI) were studied in 125 adults and 18 children who received home parenteral nutrition (HPN). METHODS: Medical records from a national home care pharmacy were reviewed for all patients that had HPN infused at least twice weekly for a minimum of two years from January 1, 2006-December 31, 2011. Infection and risk factor data were collected during this time period on all patients although those patients who received HPN for a longer period had data collected since initiation of HPN. RESULTS: In adults, 331 central venous catheters (CVCs) were placed. Total catheter years were 1157. Median CVC dwell time was 730 days. In children, there were 53 CVCs placed. Total catheter years were 113.1. Median CVC dwell time was 515 days. There were 147 CRBSIs (0.13/catheter year;0.35/1000 catheter days). In children there were 33 CRBSIs (0.29/catheter year;0.80/1000 days; P < .001 versus adults). In adults, univariate analysis showed use of subcutaneous infusion ports instead of tunneled catheters (P = .001), multiple lumen catheters (P = .001), increased frequency of lipid emulsion infusion (P = .001), obtaining blood from the CVC (P < 0.001), and infusion of non-PN medications via the CVC (P < .001) were significant risk factors for CRBSI. Increased PN frequency was associated with increased risk of CRBSI (P = .001) in children, but not in adults. Catheter disinfection with povidone-iodine was more effective than isopropyl alcohol alone. There were insufficientpatients to evaluate chlorhexidine-containing regimens. CONCLUSION: Numerous risk factors for CRBSI were identified for which simple and current countermeasures already exist.
Authors: Steven S Spires; Peter F Rebeiro; Mickie Miller; Katie Koss; Patty W Wright; Thomas R Talbot Journal: Infect Control Hosp Epidemiol Date: 2018-02-15 Impact factor: 3.254
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: Melissa A Shenep; Mary R Tanner; Yilun Sun; Tina Culley; Randall T Hayden; Patricia M Flynn; Li Tang; Joshua Wolf Journal: JPEN J Parenter Enteral Nutr Date: 2016-01-07 Impact factor: 4.016
Authors: Elizabeth Harrison; Philip Allan; Amrutha Ramu; Anil Vaidya; Simon Travis; Simon Lal Journal: World J Gastroenterol Date: 2014-03-28 Impact factor: 5.742
Authors: Arne Simon; Rhoikos Furtwängler; Norbert Graf; Hans Jürgen Laws; Sebastian Voigt; Brar Piening; Christine Geffers; Philipp Agyeman; Roland A Ammann Journal: GMS Hyg Infect Control Date: 2016-05-12