Evolution of the incidence of catheter-associated infection and possible risk factors in hospitalized patients with parenteral nutrition

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Introduction: Introduction: catheter-associated infection is one of the most serious complications related to the use of parenteral nutrition. In recent years, following the implementation of the World Health Organization's 2009 hand hygiene campaign, a reduction in nosocomial infection rates has been observed. Objectives: to compare the incidence rate of catheter-associated infection over time and to identify potential risk factors in patients receiving parenteral nutrition. Materials and methods: this was a prospective observational study including all non-critical patients over 18 years of age who required parenteral nutrition between January 2023 and June 2024 at a tertiary care hospital. The composition of the parenteral nutrition was calculated according to the patients' metabolic requirements. The incidence rate of catheter-associated infection was compared to a historical cohort from 2010 at the same hospital. Potential risk factors were analyzed. Descriptive statistics, the Student's t-test for numerical variables, and the chi-square test for categorical variables were used. Statistical analysis was performed using SPSS version 25. Results: among 695 patients, 27 developed catheter-associated infections (78.5 % male, mean age 57 ± 19 years, mean weight 67.5 ± 4.9 kg). The incidence rate was 4.5 per 1,000 catheter days, compared to 25 per 1,000 catheter days in 2010. A total of 31 infection episodes were recorded, with a predominance of Gram-positive organisms (65 %). The most frequently used vascular access was the jugular vein (52 %). No significant differences were found in age, sex, mortality, or parenteral nutrition composition between patients with and without infection. The duration of parenteral nutrition was significantly longer in patients with catheter-associated infection (21 ± 42 vs. 7 ± 10 days, p < 0.01), as also observed in the historical cohort (13.0 ± 9.7 vs. 9.3 ± 8.1 days, p = 0.038). Conclusions: in our experience, the incidence of catheter-associated infection has decreased since 2010. This reduction may be attributed to improved catheter handling practices, potentially influenced by the World Health Organization's hand hygiene recommendations since 2009. The duration of parenteral nutrition is a related risk factor.

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