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The Relationship Between Parenteral Nutrition and Central Line-Associated Bloodstream Infections: 2009-2014

Gabriela Fonseca1, Marissa Burgermaster2,3, Elaine Larson1,4

  • 1Mailman School of Public Health, Columbia University, New York, New York, USA.

JPEN. Journal of Parenteral and Enteral Nutrition
|March 6, 2018
PubMed

Insights

Parenteral nutrition (PN) significantly increases the risk of central line-associated bloodstream infections (CLABSIs). CLABSI rates in PN patients remained unchanged from 2009-2014, indicating a need for new prevention strategies.

Area of Science:

  • Infectious Diseases
  • Clinical Nutrition
  • Healthcare Quality Improvement

Background:

  • Parenteral nutrition (PN) administered via central venous catheters is a known risk factor for central line-associated bloodstream infections (CLABSIs).
  • CLABSI is a serious complication, and its prevention is a priority in healthcare settings.

Purpose of the Study:

  • To update the understanding of the relationship between PN and CLABSI.
  • To assess temporal trends in CLABSI rates among patients receiving PN from 2009 to 2014.
  • To evaluate CLABSI rates after CLABSI was declared a 'never event'.

Main Methods:

  • Retrospective analysis of adult patient discharge data from 2009-2014.
  • Inclusion of data from 38,674 patients with central lines.
  • Univariate and multivariate analyses to examine PN as a risk factor and assess temporal trends.

Main Results:

  • Parenteral nutrition (PN) was an independent risk factor for CLABSI (OR, 2.65; 95% CI, 2.20-3.19).
  • The incidence of CLABSI among patients receiving PN did not significantly change over the study period.
  • Adjusted analyses confirmed no significant temporal trend in CLABSI rates for PN patients.

Conclusions:

  • Parenteral nutrition (PN) continues to be a significant risk factor for CLABSIs.
  • Effective strategies to reduce CLABSI rates in patients receiving PN require further investigation.
  • The study highlights the persistent challenge of preventing CLABSIs in this patient population.
Abstract

Keywords:
CLABSIcentral line-associated bloodstream infectionsoutcomes research/qualityparenteral nutritionparenteral nutrition complicationssepsis

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