Overfeeding linked to CLABSI in hospitalized patients on parenteral nutrition

Overfeeding, but not underfeeding, appears to be the reason for the increased risk for central line-associated bloodstream infection (CLABSI) in hospitalized adult patients receiving parenteral nutrition (PN), suggests a recent study.

Twenty-nine patients with CLABSI were compared with 274 control participants. CLABSI was significantly more likely to develop in patients receiving greater than 30 kcal/kg/day (odds ratio [OR], 3.63, 95 percent confidence interval [CI], 1.55‒8.48; p<0.01).

No significant difference was observed in the likelihood of CLABSI development among patients receiving less than 20 kcal/kg/day (OR, 0.74, 95 percent CI, 0.21‒2.57; p=0.63).

“These results may aid clinicians in the management of patients requiring PN and in the generation of hypothesis for future investigations,” the authors said.

This case-control study was conducted in a single United States Veterans Health Administration health system to explore the potential CLABSI risk factor of weight-based PN kilocalorie dosing.

The authors identified hospitalized adult patients who developed CLABSI while receiving PN and compared these to a control group of patients who did not develop CLABSI. Subsequently, they assessed the following exposures: overfeeding (defined as greater than 30 kcal/kg/day) and underfeeding (defined as less than 20 kcal/kg/day).

“CLABSI is a complication of central venous access devices used for PN,” the authors said. “PN overfeeding is associated with increased adverse effects.”