title: [Central venous catheters-related infections in patients with parenteral nutrition].
abstract: BACKGROUND
  Infections related to central venous catheters (CVC) are complications with a high prevalence and possible serious consequences. Administration of total parenteral nutrition (TPN) is a risk factor, although the information available for these patients and conventional inpatient units is scarce.
  
  
  OBJECTIVE
  To determine the rate of catheter-related bacteremia (CRB) in patients with TPN and to identify possible relationships with administration route or place of insertion, to determinate the current situation and identify possible preventive measures.
  
  
  METHODS
  Prospective-observational study of 13 months. All adult patients who received TPN were included. Infection rate used was the CRB per 1,000 days of CVC.
  
  
  RESULTS
  176 CVC were registered in 159 patients. In 47% of CVC, vein access was jugular vein, despite being a location of greatest risk of infection. In critically ill patients, which followed a zero bacteremia project, there was no cases of infection. In other patients, bacteremia rate was 13.10 per 1,000 days of CVC. The average time elapsed between catheter insertion and infection was 11 days (range: 4-22) and the most frequent species were S. epidermidis (38%) and S. hominis (19%).
  
  
  CONCLUSIONS
  In our environment there is a high rate of BRC in non-critical patients, with a high proportion of CVC in locations with higher risk of infection, despite not having found in the sample a higher rate of infection depending on the access route. Place of insertion, operating room face ward, is related to a lower rate of BRC. Measures to standardize clinical practice may reduce its incidence. The zero bacteremia project is confirmed as a highly effective method.
authors.affiliation: Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España. rosaseisdedos@gmail.com
authors.forename: R
authors.initials: R
authors.lastname: Seisdedos Elcuaz
authors.forename: Ma C
authors.initials: MC
authors.lastname: Conde García
authors.forename: J J
authors.initials: JJ
authors.lastname: Castellanos Monedero
authors.forename: A
authors.initials: A
authors.lastname: García-Manzanares Vázquez-de Agredos
authors.forename: J C
authors.initials: JC
authors.lastname: Valenzuela Gámez
authors.forename: Ma D
authors.initials: MD
authors.lastname: Fraga Fuentes
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000453:epidemiology; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D057785:Catheters / Q000009:adverse effects*; D016638:Critical Illness; D005260:Female; D006801:Humans; D007601:Jugular Veins; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects*; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology; D013212:Staphylococcus epidermidis; D041181:Staphylococcus hominis