Intravenous glutamine or short-chain fatty acids reduce central venous catheter infection in a model of total parenteral nutrition

Background/Purpose: In children receiving total parenteral nutrition (TPN) translocated enteric organisms are a possible cause of central venous cathe ter infection. The aim of this study was to determine the relationship betw een gut mucosal atrophy, bacterial translocation, and catheter sepsis in ra ts receiving TPN alone or supplemented with intravenous short chain fatty a cids (SCFA) or glutamine. Methods: Mature Wistar rats were studied. Groups 2 to 5 had a central venou s catheter inserted. Group 1 (n = 12) had enteral feeds only, group 2 (n = 14) had enteral feeds and intravenous saline, group 3 (n = 15) had TPN only , group 4 (n = 13) had TPN with SCFA, and group 5 (n = 15) had TPN with glu tamine. At 1 week, blood, tissue, and catheter specimens were obtained for culture and mucosal morphometry. Results: Villus height and crypt depth were reduced significantly in group 3 compared with group 1 (P <.05). Glutamine and SCFA significantly ameliora ted the mucosal atrophy. Significant bacterial translocation and catheter i nfection occurred in group 3. Reduced translocation with SCFA was not signi ficant, but catheter infection was (P<.05). Glutamine significantly reduced translocation and catheter infection. Conclusions: There is an association between bacterial translocation and ce ntral venous catheter infection. The risk of catheter infection is reduced by supplementing TPN with SCFA or glutamine.