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

Main Article Content

Kritapas Chulakadabba
Bhagawat Tangaturonrasme

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.

Downloads

Download data is not yet available.

Article Details

Section
นิพนธ์ต้นฉบับ (Original Article)

References

Kullberg BJ, Arendrup MC. Invasive Candidiasis. N Engl J Med 2015;373:1445-56.

Barker LA, Gout BS, Crowe TC. Hospital malnutrition: prevalence, identification and impact on patients and the healthcare system. Int J Environ Res Public Health. 2011;8(2):514-527.

Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79.

Sriram K, Meguid MM. Addition of lipids to parenteral nutrition does not cause fungal infections. Nutrition 2015;31:1443-6.

Stratman RC, Martin CA, Rapp RP, Berger R, Magnuson B. Candidemia incidence in recipients of parenteral nutrition. Nutr Clin Pract 2010;25:282-9.

Tukenmez Tigen E, Bilgin H, Perk Gurun H, Dogru A, Ozben B, Cerikcioglu N, et al. Risk factors, characteristics, and outcomes of candidemia in an adult intensive care unit in Turkey. Am J Infect Control 2017;45:e61-e3.

Collins CJ, Fraher MH, Bourke J, Phelan D, Lynch M. Epidemiology of catheter-related bloodstream infections in patients receiving total parenteral nutrition. Clin Infect Dis 2009;49:1769-70; author reply 71-2.

Tsai CC, Lay CJ, Wang CL, Lin ML, Yang SP. Prognostic factors of candidemia among nonneutropenic adults with total parenteral nutrition. J Microbiol Immunol Infect 2011;44:461-6.

Blumberg HM, Jarvis WR, Soucie JM, Edwards JE, Patterson JE, Pfaller MA, et al. Risk factors for candidal bloodstream infections in surgical intensive care unit patients: the NEMIS prospective multicenter study. The National Epidemiology of Mycosis Survey. Clin Infect Dis 2001;33:177-86.

Stratov I, Gottlieb T, Bradbury R, O'Kane GM. Candidaemia in an Australian teaching hospital: relationship to central line and TPN use. J Infect 1998;36:203-7.

Luzzati R, Cavinato S, Giangreco M, Granà G, Centonze S, Deiana ML, et al. Peripheral and total parenteral nutrition as the strongest risk factors for nosocomial candidemia in elderly patients: a matched case-control study. Mycoses 2013;56:664-71.

Swindell K, Lattif AA, Chandra J, Mukherjee PK, Ghannoum MA. Parenteral lipid emulsion induces germination of Candida albicans and increases biofilm formation on medical catheter surfaces. J Infect Dis 2009;200:473-80.

Fleiss JL, Levin B, Paik MC. Statistical methods for rates and proportions (3rd ed.). John Wiley&Sons 2003;76.