Journal article
Association between parenteral nutrition containing intravenous lipid emulsions and bloodstream infections in patients with single-lumen central venous access: A secondary analysis of a randomized trial
Journal of Parenteral and Enteral Nutrition, Vol.47(6), pp.783-795
2023
Abstract
Background: Distinguishing primary bloodstream infections (BSIs) related to central venous access devices (CVADs) from those that occur through other mechanisms, such as a damaged mucosal barrier, is difficult.
Methods: Secondary analysis was conducted on data from patients with CVADs, collected for a large, randomized trial. Patients were divided into two groups: those who received parenteral nutrition (PN) containing intravenous lipid emulsion (ILE) and those who did not have PN containing ILE. This study investigated the influence of PN containing ILE (ILE PN) on primary BSIs in patients with a CVAD.
Results: Of the 807 patients, 180 (22%) received ILE PN. Most (627/807; 73%) were recruited from the hematology and hematopoietic stem cell transplant unit, followed by surgical (90/807; 11%), trauma and burns (61/807; 8%), medical (44/807; 5%), and oncology (23/807; 3%). When primary BSI was differentiated as a central line-associated bloodstream infection (CLABSI) or mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI), the incidence of CLABSI was similar in the ILE PN and non-ILE PN groups (15/180; 8% vs. 57/627; 9%, p=0.88) and the incidence of MBI-LCBI was significantly different between groups (31/180; 17% ILE PN vs. 41/627; 7% non-ILE PN, p<0.01).
Conclusion: Our data indicates that twice as many primary BSIs in ILE PN patients are due to mucosal barrier injuries than CVADs. It is important to consider the MBI-LCBI classification, as some CLABSI prevention efforts aimed at CVADs for the ILE PN population may be better directed to gastrointestinal tract protection interventions.
Details
- Title
- Association between parenteral nutrition containing intravenous lipid emulsions and bloodstream infections in patients with single-lumen central venous access: A secondary analysis of a randomized trial
- Authors
- Nicole C Gavin (Corresponding Author) - The University of QueenslandEmily Larsen (Author) - Griffith UniversityNaomi Runnegar (Author) - The University of QueenslandGabor Mihala (Author) - Griffith UniversitySamantha Keogh (Author) - Queensland University of TechnologyDavid McMillan (Author) - University of the Sunshine Coast, Queensland, School of Science, Technology and EngineeringGillian Ray-Barruel (Author) - Griffith UniversityClaire M Rickard (Author) - Griffith University
- Publication details
- Journal of Parenteral and Enteral Nutrition, Vol.47(6), pp.783-795
- Publisher
- John Wiley & Sons Ltd.
- Date published
- 2023
- DOI
- 10.1002/jpen.2530
- ISSN
- 1941-2444; 0148-6071
- Copyright note
- This is the peer reviewed version of the following article: Gavin, N.C., Larsen, E., Runnegar, N., Mihala, G., Keogh, S., McMillan, D., Ray-Barruel, G. and Rickard, C.M. (2023), Association between parenteral nutrition containing intravenous lipid emulsions and bloodstream infections in patients with single-lumen central venous access: A secondary analysis of a randomized trial.. J Parenter Enteral Nutr.. Accepted Author Manuscript. https://doi.org/10.1002/jpen.2530, which has been published in final form at https://doi.org/10.1002/jpen.2530. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
- Grants
- Organisation Unit
- School of Science, Technology and Engineering; Centre for Bioinnovation
- Language
- English
- Record Identifier
- 99735297702621
- Output Type
- Journal article
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- Nutrition & Dietetics
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Source: InCites