Central Catheter-related Bloodstream Infection Rates in Children on Home Parenteral Nutrition
Related Experiment Video
Updated: Jan 3, 2026
A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Ivana Trivić1, Zrinjka Mišak1,2, Višnjica Kerman1
1Children's Hospital Zagreb.
Insights
Central venous catheters are crucial for long-term parenteral nutrition but risk bloodstream infections. This study found lower infection rates at home versus in-hospital, and taurolidine line locks were not cost-effective for home PN in children.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Health Economics
Background:
- Parenteral nutrition (PN) requires reliable venous access, often via central venous catheters.
- Central venous catheters are associated with serious complications, notably catheter-related bloodstream infections (CRBSI).
- Understanding CRBSI incidence and prevention strategies is critical for patient safety in long-term PN.
Purpose of the Study:
- To assess the incidence of CRBSI in pediatric patients receiving long-term PN.
- To evaluate the cost-effectiveness of taurolidine line locks for home PN (HPN) in children.
Main Methods:
- Retrospective analysis of CRBSI data from January 2011 to January 2019 at Children's Hospital Zagreb.
- Inclusion of 48 children on long-term PN and 24 children on HPN.
- Cost-effectiveness analysis of taurolidine line lock use in HPN.
Main Results:
- Overall CRBSI rate was 1.15 per 1000 catheter days.
- In-hospital CRBSI rate was 2.35 per 1000 days; HPN rate was 0.48 per 1000 days.
- Daily use of taurolidine line locks for HPN would increase costs over fivefold compared to current CRBSI treatment costs.
Conclusions:
- CRBSI rates are significantly lower in children receiving home PN compared to inpatient settings.
- Taurolidine line locks are not a cost-effective strategy for preventing CRBSI in pediatric HPN.
- Optimizing home PN protocols may reduce CRBSI incidence effectively.
Abstract:
Reliable venous access is prerequisite for patients receiving long-term parenteral nutrition (PN). Central venous catheters are, however, an important risk factor for the development of potentially lethal complications, including catheter-related bloodstream infection (CRBSI). We have retrospectively assessed the incidence of CRBSIs in children on long-term PN who were treated at the Children's Hospital Zagreb from January 2011 until January 2019 and the cost effectiveness of the use of taurolidine line locks in children at home PN (HPN). During this period 48 children received long-term PN and 24 children were discharged to HPN. The rate of CRBSI 1.15/1000 catheter days in total; 2.35/1000 days in the hospital; and 0.48/1000 days at home. If taurolidine line lock was used every day of PN for children on HPN total costs would exceed existing CRBSI treatment costs >5 times.
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:29Endocarditis IV: Nursing Management
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:22Aneurysm IV: Nursing Management
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications