Preventing bloodstream infection in patients receiving home parenteral nutrition.

Patients receiving home parenteral nutrition (HPN) are at particularly high risk of meticillin-sensitive Staphylococcus aureus (MSSA) catheter-related bloodstream infections (CRBSI). We developed a multidisciplinary enhanced care pathway encompassing a number of minimal cost interventions involving line/exit site care, training for staff and parents, multidisciplinary discharge planning, and monitoring compliance. Implementation reduced the mean rates of MSSA CRBSI (from 0.93, 95% CI 0.25-1.61, to 0.23, 95% CI -0.06 to 0.52, per 1000 parenteral nutrition [PN] days) and all-cause CRBSI (from 1.98, 95% CI 0.77-3.19, to 0.45, 95% CI 0.10-0.80, per 1000 PN days). A similar approach could be applied to preventing health care-associated infections in other complex, vulnerable patient groups.