Catheter-related blood stream infection in patients receiving long-term home parenteral nutrition: Tertiary care hospital experience in Saudi Arabia

Abstract

Background/Aim:Parenteral nutrition (PN) is a lifesaving therapy for patients with many severe conditions, including intestinal failure. Some patients require long-term PN therapy, which makes home parenteral nutrition (HPN) an attractive option to improve the quality of life. Among the most common and serious complications observed in these patients are catheter-related blood stream infections (CRBSIs). The aim of our study is to determine the frequency of CRBSI among patients receiving long-term HPN.Patients and Methods:A retrospective chart review was conducted for patients enrolled in the HPN program between 2006 and 2012. Data on the demographic characteristics, indications and duration of PN therapy, catheter type, number of admissions because of CRBSI, and blood culture results were recorded.Results:Eight pediatric patients were included (mean age of 3.5 years at the start of HPN). Microvillus inclusive disease was noted in 50% of these patients, and 75% of them received HPN under parents' care. CRBSI resulted in 60 admissions with a median of 182 days of hospital stay and 74 changes of central venous catheters. The rate of CRBSI was 2.9 per 1000 catheter days. Staphylococcus species were the most prevalent pathogens (32%), followed by Klebsiella pneumoniae (5%).Conclusion:In this small group of HPN patients, the BSI rate was 2.9 infections per 1000 catheter days, and most common causative organisms were Staphylococcus species. We believe that a well-established training program for caregivers can reduce the rate of infectious complications associated with long-term PN support.

Molecular analysis, biofilm formation, and susceptibility of methicillin-resistant Staphylococcus aureus strains causing community- and health care-associated infections in central venous catheters

“…Staphylococcus aureus is the major pathogen causing CVC infections (39%), followed by CONS (16%) and K. pneumoniae (10%). These results agree with those of previous studies 39,40 . Most studies demonstrated that Gram-negative bacteria are the major cause of catheter-related blood stream infection, but these studies used blood samples to detect infection.…”

A Cross Sectional Survey-Based Study to Investigate the Availability and Utilisation of Home Nutrition Support in Saudi Arabia

“…12 HPN programmes are considered new in Saudi Arabia, and the first programme in the region was established in 2004 in a governmental tertiary care hospital. 18 Our study confirmed that HPN is underutilized. Thus, the underutilization of HPN services needs to be addressed by the country’s healthcare workforce.…”

Bacterial Infections among Patients with Chronic Diseases at a Tertiary Care Hospital in Saudi Arabia

“…Moreover, chronic diseases can overlap as diabetic patients are at high risk of having renal dysfunction and require hemodialysis; almost 40% of dialysis individuals are diabetic [ 21 ]. A recent study on tertiary care hospitals in Saudi Arabia observed that infections associated with bloodstream catheters occurred at a rate of 2.9 per 1000 days, and Staphylococcus species were the most common causative organisms [ 22 ]. Cardiovascular patients are also at high risk of infections because of invasive procedures used, including transplantation, congenital heart disease, and coronary artery bypass grafts.…”