Intravenous glutamine or short-chain fatty acids reduce central venous catheter infection in a model of total parenteral nutrition.
OBJECTIVE
In children receiving total parenteral nutrition (TPN) translocated enteric organisms are a possible cause of central venous catheter infection. The aim of this study was to determine the relationship between gut mucosal atrophy, bacterial translocation, and catheter sepsis in rats receiving TPN alone or supplemented with intravenous short chain fatty acids (SCFA) or glutamine.


METHODS
Mature Wistar rats were studied. Groups 2 to 5 had a central venous catheter inserted. Group 1 (n = 12) had enteral feeds only, group 2 (n = 14) had enteral feeds and intravenous saline, group 3 (n = 15) had TPN only, group 4 (n = 13) had TPN with SCFA, and group 5 (n = 15) had TPN with glutamine. At 1 week, blood, tissue, and catheter specimens were obtained for culture and mucosal morphometry.


RESULTS
Villus height and crypt depth were reduced significantly in group 3 compared with group 1 (P < .05). Glutamine and SCFA significantly ameliorated the mucosal atrophy. Significant bacterial translocation and catheter infection occurred in group 3. Reduced translocation with SCFA was not significant, but catheter infection was (P < .05). Glutamine significantly reduced translocation and catheter infection.


CONCLUSIONS
There is an association between bacterial translocation and central venous catheter infection. The risk of catheter infection is reduced by supplementing TPN with SCFA or glutamine.
Department of Child Health, The University of Liverpool, England.
H F
HF
McAndrew
D A
DA
Lloyd
R
R
Rintala
H K
HK
van Saene
D000818:Animals; D018988:Bacterial Translocation; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D016009:Chi-Square Distribution; D004195:Disease Models, Animal; D005232:Fatty Acids, Volatile / Q000008:administration & dosage / Q000494:pharmacology*; D005973:Glutamine / Q000008:administration & dosage / Q000494:pharmacology*; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D010289:Parenteral Nutrition, Total; D051381:Rats; D017208:Rats, Wistar; D018805:Sepsis / Q000209:etiology* / Q000517:prevention & control
D005232:Fatty Acids, Volatile; D005973:Glutamine