JPEN J Parenter Enteral Nutr. 2025 Nov 4. doi: 10.1002/jpen.70030. Online ahead of print.
ABSTRACT
BACKGROUND: Central line-associated bloodstream infection (CLABSI) persists as a clinical concern, contributing to increased morbidity, mortality, and healthcare costs. Prior studies have demonstrated that parenteral nutrition (PN) is associated with a small but statistically significant increase in CLABSI incidence. In this study, we evaluated the association between patients requiring PN via central venous catheter (CVC) and CLABSI, hypothesizing higher risk among patients receiving PN.
METHODS: We performed a retrospective cohort study of 25,502 adult inpatients with a CVC who were admitted to two affiliated hospitals in a large academic health system in New York City. Univariate and multivariate analyses were performed to examine the relationship between PN and CLABSI risk, with additional subgroup analyses focusing on patients in and out of the intensive care unit (ICU).
RESULTS: During the study period, 25,502 admissions were associated with a CVC, and 186 CLABSI cases were documented. When adjusting for confounders, PN was a significant risk factor for patients outside the ICU (odds ratio, 4.3; 95% confidence interval [CI], 2.4-7.9) but was not a significant risk factor for CLABSI in ICU patients. Hospital-wide, PN administration was associated with a higher risk of CLABSI when adjusting for confounders (2.3; 95% CI, 1.3-3.6).
CONCLUSION: PN is associated with an increased risk of CLABSI in ward patients but not in ICU patients, suggesting context-dependent risk. Further work is needed to determine effective strategies for reducing rates of CLABSI among patients receiving PN hospital-wide and to validate these findings in broader patient populations.
PMID:41189041 | DOI:10.1002/jpen.70030
