title: Preventing bloodstream infection in patients receiving home parenteral nutrition.
abstract: Patients receiving home parenteral nutrition (HPN) are at particularly high risk of meticillin-sensitive Staphylococcus aureus (MSSA) catheter-related bloodstream infections (CRBSI). We developed a multidisciplinary enhanced care pathway encompassing a number of minimal cost interventions involving line/exit site care, training for staff and parents, multidisciplinary discharge planning, and monitoring compliance. Implementation reduced the mean rates of MSSA CRBSI (from 0.93, 95% CI 0.25-1.61, to 0.23, 95% CI -0.06 to 0.52, per 1000 parenteral nutrition [PN] days) and all-cause CRBSI (from 1.98, 95% CI 0.77-3.19, to 0.45, 95% CI 0.10-0.80, per 1000 PN days). A similar approach could be applied to preventing health care-associated infections in other complex, vulnerable patient groups.
authors.affiliation: Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Muir
authors.forename: Christine
authors.initials: C
authors.lastname: Holden
authors.forename: Elaine
authors.initials: E
authors.lastname: Sexton
authors.forename: James W
authors.initials: JW
authors.lastname: Gray
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016331:Parenteral Nutrition, Home / Q000009:adverse effects* / Q000379:methods; D016562:Parenteral Nutrition, Home Total / Q000009:adverse effects* / Q000379:methods; D013211:Staphylococcus aureus