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Intravenous feeding in a gastroenterological unit: a prospective study of infective complications
Abstract:
We have assessed the bacteriological safety of a system of intravenous feeding by culturing catheters on removal, swabs taken from the catheter's skin entry sites, and samples of infusion fluid. Among 38 treatment periods using 51 catheters over 1551 patient days, septicaemia due to Staphylococcus aureus was observed in one treatment period and bacteraemias due to Staphylococcus albus and Diphtheroid species in two others. The Staph. aureus and the diphtheroids probably gained access via the skin entry site along the outside of the catheter. The origin of the Staph. albus was uncertain. Parenteral nutrition over extended periods can be a safe procedure if aseptic precautions are taken. The importance of the catheter's skin entry site as a source of contaiminating organisms is emphasised.
Insights
This study evaluated the safety of intravenous feeding, finding that aseptic techniques, especially at the catheter skin site, are crucial for preventing bacterial contamination and ensuring patient safety during parenteral nutrition.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Nutrition
Background:
- Intravenous feeding (parenteral nutrition) is essential for patients unable to consume food orally.
- Bacterial contamination of catheters is a significant risk factor for bloodstream infections.
- Maintaining aseptic technique is paramount in preventing catheter-related infections.
Purpose of the Study:
- To assess the bacteriological safety of a parenteral nutrition system.
- To identify potential sources of microbial contamination in intravenous feeding.
- To evaluate the role of the catheter skin entry site in infection transmission.
Main Methods:
- Culturing of removed intravenous catheters.
- Swabbing of catheter skin entry sites for microbial analysis.
- Sampling and culturing of infusion fluids.
Main Results:
- Bacteraemia occurred in 3 out of 38 treatment periods (51 catheters, 1551 patient days).
- Staphylococcus aureus and Diphtheroid species likely entered via the catheter skin site.
- Staphylococcus albus bacteraemia origin was uncertain.
Conclusions:
- Parenteral nutrition can be safe for extended periods with proper aseptic precautions.
- The catheter's skin entry site is a critical focus for preventing microbial contamination.
- Vigilance in aseptic technique is essential for safe intravenous feeding.