Septicemia and Total Parenteral Nutrition: Distinguishing Catheter-Related from other Septic Episodes

Septic episodes in 122 patients receiving total parenteral nutrition (TPN) were analyzed to determine criteria helpful in distinguishing catheterrelated septicemia from septicemia due to other causes. The five patients (4.1%) with catheter-related septicemia had positive blood and cathetertip cultures with the same organism and no other site of infection with that organism. Four of the six organisms recovered were either Candida or staphylococci. The 14 patients (11.5%) with septicemia due to other causes had positive blood cultures but negative catheter-tip cultures. Another site could be demonstrated to be infected with the same organism and was thought to be the origin of the bacteremic episode. Of the organisms recovered, 83% were gram-negative bacilli or enterococci. The implication of TPN catheters in the genesis of septicemia may be exaggerated in the literature.