{
  "abstract": "Background Home parenteral nutrition (HPN) is a mainstay of intestinal failure management. In the paediatric population parents will initially be trained to deliver this, with older children transitioning to administering this themselves where able. Ensuring children and families are trained and supported to minimise line infection is key in promoting good outcomes and preventing complications associated with HPN use. The NHS England HPN framework contract requests home PN centres to audit their central line associated bloodstream infection (CLABSI) rate. Our nutritional care team routinely reinforces this training. The British Intestinal failure alliance suggests that for patients using home parenteral nutrition ‘Units should be aspiring to an adult/young people inpatient catheter related sepsis rate of less than 3/1000 catheter days and an outpatient one of less than 1/1000 catheter days.’ 1 However it is unclear what a paediatric population should aspire to for a CLABSI rate as ‘Infants on parenteral nutrition have higher rates of catheter related sepsis.’1Aims To audit the CLABSI rate for the prior 9 years in a large hospital HPN cohort, where CLABSI is defined as a laboratory confirmed bloodstream infection where an eligible BSI organism is identified and a central line is present on the day of the BSI or within 48 hours before.To audit the catheter-related sepsis rate for the prior 9 years in a large hospital Home PN cohort, where catheter-related sepsis was defined as a febrile episode, diagnosed clinically as CVC infection by the admitting consultant and treated with a complete course of intravenous antibiotics, with or without growth on blood culture.Methods A retrospective review of electronic notes for all patients who received HPN from 1st January 2016 to 31st December 2024. Notes were reviewed to establish when patients receiving HPN had developed CLABSIs on an outpatient basis. These records were used to generate the CLABSI rate per 1000 home PN days.Results 85 patients received home PN at some point during the 9-year period audited. CLABSI rates gradually fell from a low baseline, with some variations around the COVID-19 pandemic as seen in table 1. The average CLABSI rate over the 9 years was 1.39 CLABSI per 1000 HPN days.Conclusions Our audit showed low levels of infections whichever measure was used, despite covering a paediatric population where line infections are known to occur more frequently. Continued use of a multidisciplinary care pathway for patients receiving home PN is crucial to keeping CLABSI rates low. A focus on CVC care, education and training, discharge planning and good hygiene practices enable CLABSI rates to be kept at a low level.Reference British Intestinal Failure Alliance (BIFA) position statement 2016. Home Parenteral Nutrition (HPN).Abstract OC78 Table 1CLABSI and catheter related sepsis rates per year 2016-2024YearCLABSI infection rate per 1000 HPN line daysCatheter related sepsis rate per 1000 HPN days20160.361.9920170.781.9020180.721.6420190.291.2920200.490.7820210.911.1820220.881.5920230.250.9920240.701.16",
  "authors": [
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Asdaq Ahmed"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Laura Kelly"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Gemma Kavanagh"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Sue Protheroe"
    }
  ],
  "title": "OC78 An audit of 9 years of central line associated blood stream infection rates in a paediatric home parenteral nutrition cohort",
  "uid": "5aab10e6-d363-5364-bbda-455cb6512c1d"
}