title: Catheter-related blood stream infection in patients receiving long-term home parenteral nutrition: Tertiary care hospital experience in Saudi Arabia.
abstract: OBJECTIVE
  Parenteral nutrition (PN) is a lifesaving therapy for patients with many severe conditions, including intestinal failure. Some patients require long-term PN therapy, which makes home parenteral nutrition (HPN) an attractive option to improve the quality of life. Among the most common and serious complications observed in these patients are catheter-related blood stream infections (CRBSIs). The aim of our study is to determine the frequency of CRBSI among patients receiving long-term HPN.
  
  
  METHODS
  A retrospective chart review was conducted for patients enrolled in the HPN program between 2006 and 2012. Data on the demographic characteristics, indications and duration of PN therapy, catheter type, number of admissions because of CRBSI, and blood culture results were recorded.
  
  
  RESULTS
  Eight pediatric patients were included (mean age of 3.5 years at the start of HPN). Microvillus inclusive disease was noted in 50% of these patients, and 75% of them received HPN under parents' care. CRBSI resulted in 60 admissions with a median of 182 days of hospital stay and 74 changes of central venous catheters. The rate of CRBSI was 2.9 per 1000 catheter days. Staphylococcus species were the most prevalent pathogens (32%), followed by Klebsiella pneumoniae (5%).
  
  
  CONCLUSIONS
  In this small group of HPN patients, the BSI rate was 2.9 infections per 1000 catheter days, and most common causative organisms were Staphylococcus species. We believe that a well-established training program for caregivers can reduce the rate of infectious complications associated with long-term PN support.
authors.affiliation: Pharmaceutical Care Division, King Saud University Medical City, Riyadh, Saudi Arabia.
authors.forename: Esraa S
authors.initials: ES
authors.lastname: Al-Tawil
authors.affiliation: Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: Alanoud M
authors.initials: AM
authors.lastname: Almuhareb
authors.affiliation: Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: Hamdy M
authors.initials: HM
authors.lastname: Amin
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007709:Klebsiella / Q000302:isolation & purification*; D007710:Klebsiella Infections / Q000453:epidemiology; D008297:Male; D016331:Parenteral Nutrition, Home / Q000009:adverse effects / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology; D013210:Staphylococcus / Q000302:isolation & purification*; D062606:Tertiary Care Centers