Correlation between Giving Total Parenteral Nutrition via Peripheral Vascular Access Device and Candidemia

Abstract

Background : Candidemia has been the most common cause of fungal infection in hospitals, which has been the problem in worldwide. Some of the risk factors were prolonged use of antibiotics, central venous catheter insertion, use of total parenteral nutrition, etc. However, most of the candidemia risk factor studies used parenteral nutrition(PN) via a central venous catheter, and the risk of using PN via peripheral vascular access was inconclusive.
Objectives : To study the relationship between using PN via peripheral vascular access and candidemia in hospitalized patients.

Methods : Analytic observational, retrospective matched case-control study. We identified the population from the ICU of Phramongkutklao hospital from 1 January 2016 to 30 September 2020. Using STATA14 program to analysis.
Results : There were 42 patients in the disease group and 84 in the control group. The mean age of the patient was 65-year-old. The risk factors of candidemia included recent thoracoabdominal surgery (OR 4.61, p 0.005), prolonged use of antibiotics (OR 5.01, p 0.015), using PN (OR 2.20, p 0.041), and using PN via central vascular access (OR 3.46, p 0.034) but using TPN via peripheral vascular access is not a risk factor (OR 2.11, p 0.358). Using PN via peripheral vascular access over central venous catheter did not reduce candidemia risk (HR 0.88, p 0.78).
Conclusion : Recent thoracoabdominal surgery, prolonged use of antibiotics, using PN , and using PN via a central venous catheter were associated with candidemia but not with using PN via peripheral vascular access, as the study has shown. Nevertheless, using the PN via peripheral venous access over a central venous catheter did not decrease the risk of candidemia.