Article Text
Abstract
Background and Importance Current evidence shows that the central line-associated bloodstream infections (CLABSI) frequency is between 15–30% and there are related risk factors, such as the insertion line and its duration. CLABSI is associated with high mortality and economic costs increased.
Aim and Objectives Analysing the CLABSI frequency and characteristics in patients on total parenteral nutrition (TPN) and to compare with the current data.
Material and Methods Retrospective observational study, carried out since January to April 2023 in a regional university hospital. Selected patients: all adult patients on under the care of Intensive Care Unit (ICU) and General Surgery (GS). Collected data: demographic data (sex, age),TNP duration, central venous catheter (CVC)-related data (insertion place, insertion line) and patients CLABSI diagnosed, days until the infection development and microbiological culture. Search sources: medical histories database, electronic prescription and nutrition program (CLINUS).
Results 64 patients were enrolled, 70% men, average age 60 years (SD±16). 67.19% were surgical patients and 32.81% were ICU patients. The average TPN duration was 14.7days (SD±11.43). CVC insertion places: 64% operating room and 36% ICU. The most frequent line insertion was the jugular vein (68.75%). There was 15% CLABSI diagnosed patients. The average number of days until bacteremia development was 25.4 days (SD±18.41). The most isolated microorganism was S.epidermidis (60%).
Conclusion and Relevance The CLABSI frequency in our hospital coincides with the current data. Although the subclavian vein is the most recommended because of its lower risk of infection, the jugular line has been the most frequently used in this hospital. None of the CVC were inserted on the hospital ward, which reduces the risk of infection. However, we do not have data on the lines nursing care and this is another risk factor that should be considered. The results show that CLABSI is still a common complication in patients on TPN and it is needed to increase the healthcare efforts to reduce its frequency.
References and/or Acknowledgements 1. Fonseca G, Burgermaster M, Larson E, Seres DS. The Relationship Between Parenteral Nutrition and Central Line-Associated Bloodstream Infections: 2009–2014. JPEN J Parenter Enteral Nutr. 2018 Jan;42(1):171–175. -LINK: https://pubmed.ncbi.nlm.nih.gov/29505142/
2. Lafuente Cabrero E, Terradas Robledo R, Civit Cuñado A, García Sardelli D, Hidalgo López C, Giro Formatger D, Lacueva Perez L, Esquinas López C, Tortosa Moreno A. Risk factors of catheter- associated bloodstream infection: Systematic review and meta-analysis. PLoS One. 2023 Mar 23;18(3):e0282290. -LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035840/
Conflict of Interest No conflict of interest.