Infectious Complications

Patients receiving central PN are at increased risk of developing infectious complications caused by bacterial and fungal pathogens.1,50 Infections may be related to placement of a central venous catheter, contamination of a central venous catheter or IV site (catheter-related infection), and persistent hyperglycemia. Strict aseptic techniques must be used when placing the catheter, along with continuous care of the catheter and infusion site. Catheter-related bloodstream infections are a common complication in long-term PN patients, often requiring hospital admission for parenteral antimicrobial therapy and/or removal of the catheter. Contamination of the PN admixture is possible, although rare if protocols are followed for aseptic preparation of PN admixtures. Lack of use of the intestinal tract also may increase the risk of infection possibly by reducing gut immunity, leading to intestinal bacterial overgrowth and subsequent systemic bacterial translocation.

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