Shenep et al identified risk factors for central line-associated bloodstream infection (CLABSI) in pediatric with cancer who are receiving total parenteral nutrition (TPN). This can help to identify a patient who may benefit from more aggressive management. The authors are from St. Jude Children's Hospital and the University of Melbourne.

Patient selection: pediatric patient with cancer who is receiving total parenteral nutrition


Outcome: CLABSI


The primary risk factor for CLABSI was infusion of TPN through a port (hazard ratio 40). The use of a port was also associated with increased risk of occlusion (hazard ratio 10).


Another risk factor was therapy for a solid tumor (vs hematological malignancy), possibly because of the longer period that parenteral nutrition is given.


The use of an external central venous catheter to administer TPN is associated with some risk for CLABSI (hazard ratio 2.9) but this is significantly less than for a port. This may be an option if enteral nutrition is not possible.

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