Oerskovia infection caused by contaminated home parenteral nutrition solution

Only three cases of human infection with Oerskovia have been reported. A woman receiving home total parenteral nutrition (TPN) was admitted for catheter-related sepsis caused by Oerskovia. She was discharged on an intravenous regimen of vancomycin, but symptoms recurred her first night home, and she was readmitted. Cultures of the TPN solution and peripheral blood yielded Oerskovia. The patient was successfully treated at home with 5 weeks of intravenous vancomycin therapy (30 mg/kg per day). Home TPN solutions provide an optimal incubation period for growth of microbial contaminants. Although quality control measures appropriate for hospital TPN solutions may be inappropriate for home TPN solutions, no standards currently exist for manufacturers of home TPN solutions. Thus, physicians should inquire about quality controls when choosing a company for home intravenous therapy referrals.