Effect of Delaying Replacement of Parenteral Nutrition Intravenous Administration Sets: Preclinical Experiments and a Dynamic Laboratory Model of Microbial Colonization

No Thumbnail Available
File version
Author(s)
Gavin, Nicole Clare
McMillan, David
Keogh, Samantha
Abu Choudhury, Md
Ray-Barruel, Gillian
Rickard, Claire M
Primary Supervisor
Other Supervisors
Editor(s)
Date
2018
Size
File type(s)
Location
License
Abstract

Background: Recommendations prescribe daily intravenous administration set (IVAS) replacement for parenteral nutrition (PN) comprising intravenous fat emulsions (IVFE) due to risk of micro‐organism growth and resultant central‐line associated bloodstream infections (CLABSIs), but system disconnection for this practice may allow contamination and CLABSIs.

Materials and Methods: Laboratory experiments and model development were used to simulate PN administration after contamination from healthcare workers’ hands. This study observed the growth of micro‐organisms known to cause CLABSIs in a variety of PN and other IV fluids and developed a model to investigate the effect of delaying IVAS replacement on microbial growth for up to 7 days.

Results: Micro‐organisms grew at different rates and were affected by solution type. In static experiments, growth was supported in IVFE and all‐in‐one PN, but suppressed in 50% glucose. Growth patterns were consistent over time for Staphylococcus epidermidis, Staphylococcus aureus, and Candida albicans in IVFE, all‐in‐one PN, and 0.9% sodium chloride in both static and dynamic experiments. C. albicans grew exponentially to clinically significant numbers in all‐in‐one PN and IVFE IVAS after 30 hours, but negligible growth of S. epidermidis or S. aureus occurred for 7 days.

Conclusion: All‐in‐one PN and IVFE support the C. albicans growth after minimal initial contamination, with micro‐organisms migrating from the fluid bag to the central venous access device. Improved aseptic nontouch technique during clinical practice is vital to prevent contamination. Daily IVAS replacement of for all‐in‐one PN and IVFE should continue until the safety of prolonging IVAS replacement is confirmed by randomized trials.

Journal Title
Journal of Parenteral and Enteral Nutrition
Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note
This publication has been entered into Griffith Research Online as an Advanced Online Version.
Access the data
Related item(s)
Subject
Biomedical and clinical sciences
Nursing not elsewhere classified
Persistent link to this record
Citation
Collections