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FOLEY

A Risk Factor for Central Venous Catheter-Related Infection

ABSTRACT. Background: The role of parenteral nutrition (PN) therapy as an independent risk factor for central venous catheter (CVC)-related infection in nonselected adult patients is not well established. The aim of this study was to evaluate PN as a risk factor for central venous catheterrelated infection in nonselected adult patients in a general university hospital. Methods: Patients using central venous catheters, exposed or nonexposed to PN, were prospectively followed for development of central venous catheter-related infection. Results: One hundred fifty-three patients were studied; 28 developed central venous catheter-related infection. Patients with central venous catheter-related infection presented higher frequency of PN use than patients without infection (60.7 vs 34.4%; p = .010). Multivariate Cox analysis showed that PN (relative risk (RR) = 3.30; 95% confidence interval [CI], 1.30-8.34; p = .012) was the only risk factor for central venous catheter-related infection. Malnutrition (RR = 0.45; 95% CI, 0.15-1.34; p = .152), days of hospitalization before central venous catheter insertion (RR = 1.00; 95% CI, 0.98-1.02; p = .801), and sustained hyperglycemia (RR = 0.49; 95% CI, 0.98-1.21; p = .091) were not significant in the model. Multiple logistic regression revealed that malnutrition (odds ratio [OR] = 8.05; 95% CI, 1.85-35.03; p = .005), central venous catheter indication for surgical-related pathology (OR = 7.26; 95% CI, 2.51-21.04; p

Parenteral nutrition (PN) is indicated in patients unable to obtain nutrients by the enteral route in order to prevent the adverse effects of malnutrition.1 The benefits of this therapy to improve nutrition status are well recognized.2 In addition, PN plays a significant role in the outcome of surgery in severely malnourished patients, in patients with short-bowel syndrome, and in critically ill patients.1

Foley Catheters.

However, controversies regarding the impact of PN on mortality and overall morbidity still remain,1,3 especially due to the presence of PN-associated complications.4 One of the most serious complications of PN is catheter-related sepsis, which has been reported to occur in 1.3%-26.2% of the catheters used to administer PN.5-9 Such wide range of frequencies could be explained by differences in the design of studies investigating central venous catheter (CVC)-related bloodstream infection (BSI), in the criteria used to define CVC-related infection and in the type of catheter used, or by the inclusion of only selected groups of patients and the catheter management by teams with varying degrees of skill.  Male External Catheters, Silicone Catheters, Urological Catheters.

PN was first identified as a risk factor for CVC-related infection in the 1970s.10-12 Later, additional studies confirmed this association.13-19 Nevertheless, data confirming PN as an independent risk factor for CVC-related infection according to multivariate analysis are still scarce.13,17 Furthermore, studies often focus receiving PN in patients from intensive care units (ICUs).13,17 Therefore, the role of PN therapy as a risk factor for CVC-related infection in nonselected adult patients is still uncertain.

The aim of this study was to evaluate PN as a risk factor for CVC-related infection in nonselected adult patients from a general university hospital.

Foley Catheters, Male External Catheters, Silicone Catheters, Urological Catheters, Foley.