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June 1979

Gram-Negative Bacillary Sepsis Associated With Use of Lipid Emulsion in Parenteral Nutrition

Author Affiliations

Department of Pediatrics; Department of Medicine; Department of Pediatrics; Department of Medicine Children's Hospital Vanderbilt University School of Medicine Nashville, TN 37232

Am J Dis Child. 1979;133(6):649-650. doi:10.1001/archpedi.1979.02130060089023

The use of solutions for parenteral nutrition has greatly enhanced the management of medical and surgical disorders. Two general classes of solutions are employed: total parenteral nutrition solutions (TPN), containing a mixture of amino acids, glucose, electrolytes, and vitamins, and soybean oil emulsion (Intralipid). Both solutions have been shown to support the growth of bacteria and fungi.1,2 Although sepsis is a recognized complication of the use of TPN solutions,2 there have been no reports of infection with the use of lipid emulsion. We report two distinct episodes of lipid emulsion-associated sepsis with two different Gram-negative microorganisms in a chronically ill infant.

Report of a Case.—An infant with complications resulting from a midgut volvulus required parenteral nutrition at 3½ months of age and a central venous catheter was inserted. Both glucose-amino acid (TPN) solution and lipid emulsion were administered via a "Y" configuration delivery system. A 0.22-μ particle

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