Epidemiology of bloodstream infections in patients receiving long-term total parenteral nutrition

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dc.contributor.authorMarra, Alexandre R.
dc.contributor.authorOpilla, Marianne
dc.contributor.authorEdmond, Michael B.
dc.contributor.authorKirby, Donald F.
dc.contributor.institutionVirginia Commonwealth Univ
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T12:41:46Z
dc.date.available2016-01-24T12:41:46Z
dc.date.issued2007-01-01
dc.description.abstractGoals: To describe the epidemiology and microbiologic characteristics of bloodstream infections (BSIs) in patients receiving long-term total parenteral nutrition (TPN).Background: Home TPN therapy has been reported as a risk factor for BSI. However, little knowledge exists regarding the epidemiology of BSIs in this patient group.Study: A descriptive, observational epidemiologic study of patients receiving long-term TPN from January 1981 to July 2005 was performed. Variables analyzed include age, gender, time of follow-up, number of BSIs, microbiologic characteristics, underlying disease necessitating long-term TPN, catheter type, complications related to TPN, and clinical outcome.Results: Forty-seven patients receiving long-term TPN were evaluated. the most frequent indication for long-term TPN was ischemic bowel disease (25.5%). the mean duration of follow-up was 4.5 years. Thirty-eight patients (80.9%) developed 248 BSls while receiving TPN. More than 1 BSI episode occurred in 78.9% of these patients, and 23.8% of BSI episodes were polymicrobial. the most prevalent pathogen was coagulase negative staphylococci (33.5%). the most frequent complication among patients with BSI was central venous thrombosis (44.7%). Five patients were intravenous drug users. There were 11 deaths among the patients on long-term TPN, 4 of these were related to infection and 4 were related to intravenous drug use.Conclusions: the incidence of BSI is high, and a significant proportion of BSIs in long-term TPN patients are polymicrobial and due to multidrug-resistant bacteria and fungi. Careful management of the infusion line is required and interventions are needed to reduce the risk of catheter-related infections in this population.en
dc.description.affiliationVirginia Commonwealth Univ, Med Coll Virginia, Dept Internal Med, Richmond, VA 23298 USA
dc.description.affiliationUNIFESP, EPM, Div Infect Dis, São Paulo, Brazil
dc.description.affiliationVirginia Commonwealth Univ, Ctr Med, Dept Surg Nursing, Richmond, VA 23298 USA
dc.description.affiliationUnifespUNIFESP, EPM, Div Infect Dis, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent19-28
dc.identifierhttp://dx.doi.org/10.1097/01.mcg.0000212606.13348.f7
dc.identifier.citationJournal of Clinical Gastroenterology. Philadelphia: Lippincott Williams & Wilkins, v. 41, n. 1, p. 19-28, 2007.
dc.identifier.doi10.1097/01.mcg.0000212606.13348.f7
dc.identifier.issn0192-0790
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/29416
dc.identifier.wosWOS:000243269700004
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofJournal of Clinical Gastroenterology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectepidemiologyen
dc.subjecttotal parenteral nutritionen
dc.subjectbloodstream infectionen
dc.titleEpidemiology of bloodstream infections in patients receiving long-term total parenteral nutritionen
dc.typeinfo:eu-repo/semantics/article
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