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Central Venous Catheter Infections and Antibiotic Therapy During Long‐Term Home Parenteral Nutrition
Author(s) -
Santarpia Lidia,
Alfonsi Lucia,
Tiseo Domenico,
Creti Roberta,
Baldassarri Lucilla,
Pasanisi Fabrizio,
Contaldo Franco
Publication year - 2010
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607110362900
Subject(s) - parenteral nutrition , medicine , central venous catheter , intensive care medicine , antibiotics , catheter , term (time) , antibiotic therapy , intravenous antibiotics , intravenous therapy , surgery , microbiology and biotechnology , biology , physics , quantum mechanics
Background: Catheter‐related bloodstream infections are a serious and common complication in patients receiving home parenteral nutrition (HPN). Methods: Prevalence of infections, type of agents, and effectiveness of antibiotic therapy were evaluated in 296 patients (133 males, 163 females; mean age 58.2 ± 13.5 years) receiving HPN for at least 3 months, from January 1995 to December 2006. Patients underwent 99,969 (331 ± 552; minimum 91, maximum 4353) days of catheterization, corresponding to 93,236 (311 ± 489; minimum 52, maximum 4353) days of HPN. Results: Fifty‐two patients (24 males and 28 females; 35 oncological and 17 nononcological) were diagnosed with 169 infections. The overall corresponding infection rate was 2.0 per 1000 days of catheterization, with a progressive, regular decrease with time. In 30 cases, immediate central venous catheter removal was necessary. Infections were eradicated in 103 of 139 (74%) cases. As to the most common causative agent, 86 (51%) infections were due to Staphylococcus epidermidis . Of these, 64 were treated from 1995 to 2004, 57 of them (89%) successfully; 22 were treated from 2005 onward, only 7 of them (32%) successfully. Conclusions: Although the global infection rate has progressively decreased over the years, S epidermidis has shown an alarming increase in resistance to antibiotic treatment in the last 2 years, suggesting the need for strategies to prevent central venous catheter infection.