Parenteral Nutrition Total Energy Dosing and Risk for Central Line-Associated Bloodstream Infection: A Case-Control...

Area of Science:

• Clinical Nutrition
• Infectious Disease Epidemiology
• Patient Safety

Background:

• Central line-associated bloodstream infection (CLABSI) is a serious complication for patients requiring central venous access devices for parenteral nutrition (PN).
• While PN overfeeding is linked to adverse effects, its specific impact on CLABSI risk remains unclear.

Purpose of the Study:

• To investigate the association between recommended total energy dosing in parenteral nutrition and the risk of CLABSI in hospitalized adult patients.
• To determine if PN overfeeding or underfeeding influences the incidence of CLABSI.

Main Methods:

• A case-control study was conducted within a US Veterans Health Administration system.
• Patients with CLABSI receiving PN (cases) were compared to those without CLABSI (controls).
• Exposure variables included overfeeding (>30 kcal/kg/day) and underfeeding (<20 kcal/kg/day) of PN.

Main Results:

• Twenty-nine CLABSI cases and 274 controls were analyzed.
• Patients receiving overfeeding (>30 kcal/kg/day) had significantly higher odds of CLABSI (OR, 3.63; P < .01).
• No significant difference in CLABSI odds was observed for patients receiving underfeeding (<20 kcal/kg/day).

Conclusions:

• Parenteral nutrition overfeeding is associated with an increased risk of CLABSI in hospitalized adults.
• Underfeeding PN does not appear to significantly affect CLABSI risk.
• Findings can inform PN management and guide future research on CLABSI prevention.