[Parenteral nutrition from the viewpoint of the hospital health officer].

This paper reviews recent data concerning epidemiology, pathogenesis, diagnosis, prevention and management of infectious complications of intravascular devices used for parenteral nutrition. Infectious complications of intravascular access for parenteral nutrition occur frequently. Any time there is a strong suspicion of a vascular access infection, it is important to draw blood cultures. The type of isolated organism may indicate the source of infection, e.g. the skin, hematogenous dissemination from another site or the infusate. Prevention of vascular access infection is preferable to treatment. Standardized insertion and maintenance techniques by specialized i.v. teams can substantially reduce the risk of infection. In-line filters or guidewires for changing catheters are of no proven benefit in decreasing infection risk, whereas transparent plastic dressings and multilumen lines increase infection risk. Treatment of established infection, e.g. removal of the catheter and/or antibiotic therapy, must be individualized for each patient on the basis of clinical presentation and causative organism.