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

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

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

Correspondence: Mirela J. de Azevedo, MD, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350/Prédio 12/4° andar, 90035–003 Porto Alegre, RS, Brazil. Electronic mail may be sent to mirelaazevedo{at}terra.com.br.

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 mal-nutrition (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 Nutrition, Vol. 29, No. 5, 367-373 (2005)
DOI: 10.1177/0148607105029005367


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