Central venous catheter related bloodstream infections in adult patients on home parenteral nutrition: Prevalence, predictive factors, therapeutic outcome.
BACKGROUND
The prevalence of central venous catheter (CVC)-related blood-stream infections (CRBSI), infecting agents and the effectiveness of antibiotic therapy were evaluated in 172 adult patients on Home Parenteral Nutrition (HPN) at the Clinical Nutrition Outpatient Unit of Federico II University Hospital in Naples, Italy.


MATERIALS AND METHODS
The study population consisted of 127 oncological (74%) and 45 (26%) non-oncological patients, for a total of 53,818 (median 104; range 14-1080) CVC days.


RESULTS
Ninety-four CRBSIs were diagnosed on 238 CVC (infection rate 1.74/1000 CVC days). Coagulase negative (CoNs) Staphylococci were the most frequently infecting agents (52.8% as single agent) with 17.1% Staphylococcus epidermidis infections. Eighty-three percent S. epidermidis were beta-lattamase producer (BLACT), 66.6% methicillin-resistant (MR) and 55.5% had a MIC for Vancomicin ≥1. Gram-negative bacteria represented 18.6% infections, fungi 7.1%, finally 15% infections were polymicrobial. Previous catheterizations and the presence of an enterocutaneous stoma were significantly related with a higher infection risk (p < 0.0001 in both cases).


CONCLUSIONS
CRBSI and antibiotic resistance of infecting agents remain an important challenge in adult patients on HPN; an active research on strategies to counteract the phenomena is required.
['Santarpia|Lidia|L|', 'Buonomo|Antonio|A|', 'Pagano|Maria Carmen|MC|', 'Alfonsi|Lucia|L|', 'Foggia|Maria|M|', 'Mottola|Michele|M|', 'Marinosci|Geremia Zito|GZ|', 'Contaldo|Franco|F|', 'Pasanisi|Fabrizio|F|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D000900:Anti-Bacterial Agents D016470:Bacteremia D055499:Catheter-Related Infections D062905:Central Venous Catheters D003141:Communicable Diseases D005260:Female D006801:Humans D007558:Italy D008297:Male D008875:Middle Aged D016331:Parenteral Nutrition, Home D015995:Prevalence D012189:Retrospective Studies D012307:Risk Factors D016896:Treatment Outcome D055815:Young Adult
Central venous catheters Home parenteral nutrition Antibiotic resistance Catheter related blood-stream infections