{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T15:37:30Z","timestamp":1760888250664,"version":"build-2065373602"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[1998,9,1]],"date-time":"1998-09-01T00:00:00Z","timestamp":904608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[1998,9]]},"abstract":"<jats:p><jats:italic>Background:<\/jats:italic> The extraordinary growth properties of most microorganisms in 10% and 20% lipid emulsions has led to the Centers for Disease Control and Prevention recommendation that if lipids are given through an IV line, the administration set should be replaced every 24 hours rather than the usual 72\u2010hour interval used for crystalloid solutions, including those used for conventional total parenteral nutrition. For nearly 15 years, parenteral alimentation has been given as a total nutrient admixture (TNA), with the glucose, amino acids, and lipid mixed within the same bag and infused continuously over 24 hours. Methods: We prospectively studied in a representative TNA (17.6% glucose, 5% amino acids, 4% lipid; pH 5.6, osmolality 1778) and in a control solution, 5% dextrose\u2010in\u2010water (D5%\/W), the growth properties at 4, 25, and 35\u00b0C of three isolates each of <jats:italic>Staphylococcus epidermidis, Staphylococcus aureus, Enterobacter cloacae, Klebsiella oxytoca, Serratia marcescens, Acinetobacter calcoaceticus, Stenotrophomonas maltophilia, Pseudomonas aeruginosa, Burkholderia cepacia, Flavobacterium spp, and Candida albicans,<\/jats:italic> and two isolates of <jats:italic>Staphylococcus saprophyticus,<\/jats:italic> the species that are most likely to contaminate TNA during preparation or administration and that have been implicated in &gt;95% of all outbreaks and sporadic cases of nosocomial bloodstream infections traced to contaminated parenteral admixtures reported in the world literature. <jats:italic>Results:<\/jats:italic> Growth in TNA at 25 and 35\u00b0C occurred with only two species, <jats:italic>C. albicans<\/jats:italic> and S. <jats:italic>saprophyticus,<\/jats:italic> and only after 24 to 48 hours; D5%\/W allowed growth at 25\u00b0C of two Gram\u2010negative species, S. <jats:italic>marcescens<\/jats:italic> and B. <jats:italic>cepacia. Conclusions:<\/jats:italic> We conclude that TNA is a poor growth medium for most nosocomial pathogens and is no better than D5%\/W The need to replace administration sets every 24 hours with TNA should be reconsidered and ideally be studied in a prospective randomized trial. <jats:italic>(Journal of Parenteral and Enteral Nutrition<\/jats:italic> <jats:bold>22:<\/jats:bold>291\u2013296,1998)<\/jats:p>","DOI":"10.1177\/0148607198022005291","type":"journal-article","created":{"date-parts":[[2008,5,14]],"date-time":"2008-05-14T19:51:26Z","timestamp":1210794686000},"page":"291-296","source":"Crossref","is-referenced-by-count":41,"title":["Total Nutrient Admixtures Appear Safer than Lipid Emulsion Alone as Regards Microbial Contamination: Growth Properties of Microbial Pathogens at Room Temperature"],"prefix":"10.1002","volume":"22","author":[{"given":"Maria E.","family":"Didier","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelly","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis G.","family":"Maki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1998,9]]},"reference":[{"key":"e_1_2_1_2_1","first-page":"1260","article-title":"Infection control in total parenteral nutrition","volume":"223","author":"Goldman DA","year":"1973","journal-title":"J Am Med Assoc"},{"key":"e_1_2_1_3_1","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1177\/0148607185009006735","article-title":"Infection control during parenteral nutrition therapy","volume":"9","author":"Williams 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