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New guidelines needed to prevent infection from IV feeding

Current measures too weak, study finds

Jo Carlowe

Thursday, 26 June 2014

Current guidelines to help prevent bloodstream infections during intravenous feeding need revising.

This is the finding from researchers at the University of Southampton who, in a study* published today OnlineFirst in the Journal of Parenteral and Enteral Nutrition (JPEN), conclude that current guidelines do not account for independent factors that can affect the growth of potentially deadly microorganisms. 

Existing guidelines restrict how long a single bag of parenteral nutrition (PN) containing lipids can be used due to the ability of lipids to encourage the growth of microorganisms. This study looked at the growth of Escherichia coli (E coli) and Enterococcus durans (E durans) in PN to see if other factors can affect microbial growth.

The study found that additional factors, including glucose concentration, proportion of glucose to lipid, and osmolarity, can affect microbial growth apart from the presence of lipids.

The study's researchers recommend that these additional factors should be considered when making clinical and policy decisions to limit the potential growth of microorganisms in PN.

The study is timely, given the recent case of blood poisoning of newborns caused by an infected batch of intravenous fluid distributed to a number of hospitals in London and the south-east of England. 

* Austin P D, Hand K S, Elia M. Factors Influencing Escherichia coli and Enterococcus durans Growth in Parenteral Nutrition With and Without Lipid Emulsion to Inform Maximum Duration of Infusion Policy Decisions. JPEN J Parenter Enteral Nutr June 25, 2014. doi: 10.1177/0148607114538456

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