Parenteral Nutrition as a Risk Factor for Central Venous Catheter-Related Infection

Beghetto, Mariur G. RN
Victorino, Josué MD
Teixeira, Luciana RN
de Azevedo, Mirela J. MD

From the^*Nursing,^†Intensive Care, and^‡Endocrine Divisions, Hospital de Clýnicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil

Received for publication March 10, 2004.

Accepted for publication April 22, 2005.

Correspondence: Mirela J. de Azevedo, MD, Servic,o de Endocrinologia, Hospital de Clýicas de Porto Alegre, Rua Ramiro Barcelos 2350/Preacutedio 12/4° andar, 90035–003 Porto Alegre, RS, Brazil. Electronic mail may be sent to mirelaazevedocommatterra.com.br.

Journal of Parenteral and Enteral Nutrition 29(5):p 367-373, September-October 2005.

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 catheter-related 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 < .001), sustained hyperglycemia (OR = 4.34; 95% CI, 1.79–10.52; p = .001), and days of hospitalization before central venous catheter insertion (OR = 1.04; 95% CI, 1.01–1.07; p = .004) were associated with PN use after adjustment for Assessment Score Intervention System score (OR = 0.33; 95% CI, 0.14–0.80; p = .014).

Conclusions:

PN therapy is an independent risk factor for central venous catheter-related infection in nonselected hospitalized adult patients. (Journal of Parenteral and Enteral Nutrition29:367–373, 2005)