Water Soluble Vitamins Enhance the Growth of Microorganisms in Peripheral Parenteral Nutrition Solutions

Omotani, Sachiko; Tani, Katsuji; Nagai, Katsutoshi; Hatsuda, Yasutoshi; Mukai, Junji; Myotoku, Michiaki

doi:10.7150/ijms.21424

Cited by 5 publications

(7 citation statements)

References 17 publications

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“…The growth rate with PPN was equally robust as with fat emulsion or blood preparations (albumin). In this study we demonstrated that B. cereus proliferates in PPN, in addition to other organisms such as E. coli , S. marcescens , K. pneumoniae , and P. aeruginosa, reported by Omotani et al 31 . In the CDC Guideline for the Prevention of Intravascular Catheter-Related Infections, it is prescribed that tubing used to administer blood, blood products, or lipid emulsion should be replaced within 24 h after the initiation of infusion 32 .…”

Section: Discussionsupporting

confidence: 74%

Peripheral Parenteral Nutrition Solutions and Bed Bath Towels as Risk Factors for Nosocomial Peripheral Venous Catheter-related Bloodstream Infection by Bacillus cereus

Hino¹,

Ozaki²,

Kitahara³

et al. 2023

Int. J. Med. Sci.

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In Japan, China, and Singapore, several studies have reported increased incidences of peripheral venous catheter-related bloodstream infection by Bacillus cereus during the summer. Therefore, we hypothesized that bed bathing with a B. cereus -contaminated “clean” towels increases B. cereus contact with the catheter and increases the odds of contaminating the peripheral parenteral nutrition (PPN). We found that 1) professionally laundered “clean” towels used in hospitals have B. cereus (3.3×10 4 colony forming units (CFUs) / 25cm 2 ), 2) B. cereus is transferable onto the forearms of volunteers by wiping with the towels (n=9), and 3) B. cereus remain detectable (80∼660 CFUs /50cm 2 ) on the forearms of volunteers even with subsequent efforts of disinfection using alcohol wipes. We further confirmed that B. cereus grow robustly (10 2 CFUs /mL to more than 10 6 CFUs /mL) within 24hours at 30°C in PPN. Altogether we find that bed bathing with a towel contaminated with B. cereus leads to spore attachments to the skin, and that B. cereus can proliferate at an accelerated rate at 30°C compared to 20°C in PPN. We therefore highly recommend ensuring the use of sterile bed bath towels prior to PPN administration with catheter in patients requiring bed bathing.

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Section: Discussionsupporting

confidence: 74%

Peripheral Parenteral Nutrition Solutions and Bed Bath Towels as Risk Factors for Nosocomial Peripheral Venous Catheter-related Bloodstream Infection by Bacillus cereus

Hino¹,

Ozaki²,

Kitahara³

et al. 2023

Int. J. Med. Sci.

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“…Nutrients required for growth differ depending on the bacterial species, and there have been reports on the growth characteristics of bacteria in commercially available PPN and total parenteral nutrition (TPN) solutions 33 - 36 . We have previously demonstrated that C. albicans do not grow in commercial PPN solutions but rather grow significantly in PPN solutions with biotin 37 .…”

Section: Discussionmentioning

confidence: 99%

“…Shiraishi et al reported that S. aureus grow in TPN solutions containing lipid emulsions 33 . In addition, it has been reported that S. aureus require nicotinamide 36 . It was also found that S. epidermidis and P. aeruginosa hardly colonize in the catheter lumen and grow slowly after 48 and 72 h (Figs.…”

Section: Discussionmentioning

confidence: 99%

“…It was also found that S. marcescens slightly colonize and proliferate in the catheter lumen and increase significantly at 48 and 72 h (Figure 2 D). Omotani et al reported that S. marcescens grow well in PPN solutions, which are less nutritious than TPN solutions 36 . In addition, it was found that C. albicans proliferates rapidly 48 and 72 h after colonization in the catheter lumen (Figure 2 F).…”

Section: Discussionmentioning

confidence: 99%

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Bactericidal and Antiproliferative Effects of Peripheral Parenteral Nutrition Solutions with Sodium Bisulfite on Pathogenic Microorganisms in Catheter Lumens

Ohara¹,

Watanabe²,

Takebayashi³

et al. 2020

Int. J. Med. Sci.

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Catheter-related bloodstream infections (CRBSIs) due to pathogenic microorganisms pose a major threat to patients requiring parenteral nutrition (PN). Additives contained in medicines and foods have antiproliferative and bacteriostatic effects on pathogenic microorganisms. Therefore, PN solutions containing additives may also have an antibacterial effect. However, so far, there have been no reports on or observations of a PN solution with bactericidal activity. In this study, we assessed several nutrition solutions with antimicrobial activities and investigated their effects on pathogenic microorganisms colonizing catheter lumens. We selected the highly acidic Plas-Amino ® (PA), which contains a large amount of sodium bisulfite as a preservative and potentially has an antimicrobial effect. In this study, we used the following pathogenic bacteria as the main causatives of CRBSIs: Staphylococcus aureus , Staphylococcus epidermidis , Bacillus cereus , Serratia marcescens , Pseudomonas aeruginosa , and Candida albicans . We then created a catheter lumen microorganism contamination model and evaluated the antibacterial effect of PA; we found that all bacteria in the control group grew significantly in the catheter lumen in a time-dependent manner at 48 and 72 h. On the other hand, we demonstrated that PA has bactericidal effects on S. aureus , S. epidermidis , B. cereus , S. marcescens , and P. aeruginosa in the catheter lumen and confirmed that it has a remarkable antiproliferative effect on C. albicans . Hence, we concluded that highly acidic PN solutions that contain a preservative like sodium bisulfite have bactericidal and growth inhibition effects on microorganisms in the catheter lumens of patients with CRBSIs and patients with totally implantable central venous access devices, in whom it is difficult to remove the catheter.

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“…Peripheral PN may be indicated for short-term use or as a supplement typically to maintain a previously well-nourished, patient or to serve as a bridge to centrally administered infusions or until adequate enteral feedings can be established [12,13]. The risk of microbial contamination and following growth is greater with peripheral PN than with PN, mainly due to the lower osmolarity in peripheral PN [14]. Moreover, the risk of phlebitis and extravasation is high and causes catheter removal [15].…”

Section: Accesses For Artificial Nutritionmentioning

confidence: 99%

Pharmaceutical Aspects of Artificial Nutrition

Reber

Messerli

Stanga

et al. 2019

JCM

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Artificial nutrition, including enteral (EN) and parenteral (PN) nutrition, is indicated whenever adequate oral nutrition fails to sufficiently supply the necessary nutrients to the body. It is a convenient, efficacious, safe, and well-tolerated form of clinical nutrition in the hospital and home setting. EN is administered via nasogastric tube or ostomies while PN usually requires a central venous access for administration, straight into the blood stream. The infused nutrients can then be taken up directly by the different organs. PN is targeted as a single daily portion formulated as an oil-in-water emulsion providing the necessary substrates for the catabolic and anabolic metabolism including macro- and micronutrients and fluids. PN has a complex pharmaceutical composition—all-in-one admixture—and its compounding or ready-to-use preparation. The use of PN is more challenging and more expensive compare to the use of EN, commercially available as ready-to-use formulations. EN and concomitant medication is highly challenging. Upon incorrect handling and administration, PN is associated with potentially severe or even fatal complications, mostly relating to the central venous access (e.g., catheter-related sepsis) or to a metabolic intolerance (e.g., hyperglycemia, refeeding syndrome) because of inappropriate administration. A correct order of admixing, correct dosing, and administration of the artificial is crucial for safety and efficacy; clinical and biochemical monitoring of the patient and treatment regimen adaption are necessary. The high number of reactive solutes allow only limited stability of a ready-to-use PN admixture. The potential for numerous incompatibilities and interactions renders PN admixtures generally unsuitable as drug vehicle. Laboratory compatibility and stability testing and pharmaceutical expertise are a prerequisite to define the PN composition including nutrients or even drugs admixed to define the appropriate and individualized nutrition and medication regimen. The aim of this narrative review is to present the actual state-of-the-art to deliver best quality artificial nutrition with special regard on pharmaceutical aspects such as instabilities, incompatibilities, and concomitant co-medication.

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Water Soluble Vitamins Enhance the Growth of Microorganisms in Peripheral Parenteral Nutrition Solutions

Cited by 5 publications

References 17 publications

Peripheral Parenteral Nutrition Solutions and Bed Bath Towels as Risk Factors for Nosocomial Peripheral Venous Catheter-related Bloodstream Infection by Bacillus cereus

Peripheral Parenteral Nutrition Solutions and Bed Bath Towels as Risk Factors for Nosocomial Peripheral Venous Catheter-related Bloodstream Infection by Bacillus cereus

Bactericidal and Antiproliferative Effects of Peripheral Parenteral Nutrition Solutions with Sodium Bisulfite on Pathogenic Microorganisms in Catheter Lumens

Pharmaceutical Aspects of Artificial Nutrition

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