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Association of Malnutrition with Nosocomial Infection

Published online by Cambridge University Press:  21 June 2016

Geoffrey J. Gorse ,
Roberta L. Messner  and
Nancy D. Stephens
Geoffrey J. Gorse*
Affiliation:
Section of Infectious Diseases and Immunology, Department of Medicine, Huntington Veterans Administration Medical Center, Marshall University School of Medicine, Huntington, West Virginia
Roberta L. Messner
Affiliation:
Infection Control Nursing Service, Huntington Veterans Administration Medical Center, Huntington, West Virginia
Nancy D. Stephens
Affiliation:
Dietetics Service, Huntington Veterans Administration Medical Center, Huntington, West Virginia
*
Division of Infectious Diseases, Department of Internal Medicine. School of Medicine, St. Louis Uuiversity Medical Center, 1402 South Grand Blvd., St. Louis, MO 63104
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Abstract

To study the association of malnutrition with nosocomial infection in a general medical and surgical inpatient population, we retrospectively compared 45 patients with nosocomial infection to 45 uninfected control patients, matched using several nonnutritional variables known to predispose to nosocomial infection. Univariate and multivariate analyses were done. Poor nutritional score (derived from serum albumin, total lymphocyte count, and unintentional body weight loss), unintentional body weight loss, low serum albumin level at both time of admission and the first nosocomial infection, and worsening in the nutritional score and serum albumin from admission to the first nosocomial infection were associated with the development of nosocomial infection. Nutritional factors were more abnormal in subgroups of patients with nosocomial pneumonia, urinary tract infection, wound infection, and bacteremia than in controls. The findings suggest that further study of correlations between nutritional factors and nosocomial infections is needed.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 10 , Issue 5 , May 1989 , pp. 194 - 203
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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References

1. Reinhardt, GE Myscofski, JW. Wilkens, DB, et al: Incidence and mortality of hypoalbuminemic patients in hospitalized veterans. JPENJ Parenter Enteral Nutr. 1980;4:357–359.Google Scholar
2. Keusch, GT: Nutrition and infection, in Remington, JS, Swartz, NN (eds): 5. Current Clinical Topics in infectious Diseases. New York, McGraw-Hill Book Co., 1984, pp 106–123.Google Scholar
3. Bistrian, BR, Blackburn, GL, Hallowell, E. et al: Protein status of general surgical patients. JAMA. 1974;230:858–860.Google Scholar
4. Bistrian, BR, Blackburn, GL, Vitale, J. et al: Prevalence of malnutrition in general medical patients. JAMA. 1976;235:1567–1570.Google Scholar
5. Bienia, R, Ratcliff, S, Barbour, GL, et al: Malnutrition in the hospitalized geriatric patient. J Am Gerintr Soc 1982;30:433–436.Google Scholar
6. Scrimshaw, NS. Taylor, CE. Gordon, JE: Interactions of Nutrition and Infection. Monograph Series. No. 57, Geneva, World Health Organization, 1968.Google Scholar
7. Cannon, PR: The importance of proteins in resistance to infection. JAMA. 1945;128:360–362.Google Scholar
8. Rhoads, JE, Alexander, CE: Nutritional problems of surgical patients. Ann NY Acad Sci. 1955;63:268–275.Google Scholar
9. Shukla, VK, Roy, SK, Kumar, J. et al: Correlation of immune and nutritional status with wound complications in patients undergoing abdominal surgery. Am Sing. 1985;51:442–445.Google Scholar
10. Blackburn, GL: Nutritional assessment and support during infection. Am J Clin Nutr. 1977;30:1493–1497.CrossRefGoogle ScholarPubMed
11. Harvey, KB. Moldawer, LL, Bistrian, BR. et al: Biological measures for the formulation of a hospital prognostic index. Am J Clin Nutr. 1981;34:2013–2022.Google Scholar
12. Law, DK, Dudrick, SI, Abdou, NI: The effects of protein caloric malnutrition on immune competence of the surgical patient. Surg Gynecol Obstet. 1974;139:257–266.Google Scholar
13. MacLean, LD, Meakins, JL. Taguchi, K, et al: Host resistance in sepsis and traunna. Am Surg. 1975;182:207–217.Google Scholar
14. Mullen, IL, Buzby, GP, Waldman, MT, et al: Prediction of operative morbidity and mortality by preoperative nutritional assessment Abstracted. Singnial Forum. 1979;30:80–82.Google Scholar
15. Lewis, RT. Klein, H: Risk factors in postoperative sepsis: Significance of preoperative lymphocytopenia. J Surg Res 1979;26:365–371.CrossRefGoogle ScholarPubMed
16. Mullen, IL, Gertner, MH, Buzby, GP. et al: Implications of malnutrition in the surgical patient. Arch Surg 1979;114:121–125.Google Scholar
17. Buzby, GP. Mullen, IL. Matthews, DC. et al: Prognostic nutritional index in gastrointestinal surgery. Am J Surg. 1980;139:160–167.Google Scholar
18. Hickman, DM. Miller, RA. Rombeau, JL, et al: Serum albumin and body weight as predictors of postoperative course in colorectal cancer. JPEN J Parenter Enteral Mutr. 1980;1:314–316.Google Scholar
19. Garibaldi, RA, Britt, MR, Coleman, ML. et al: Risk lactors for postoperative pneumonia. Am J Med 1981;70:677–680.Google Scholar
20. Anderson, CF, Wochos, DN: The utility of serum albumin values in the nutritional assessment of hospitalized patients. Mayo Clin Proc 1982;57:181–184.Google ScholarPubMed
21. Brown, R. Bancewicz, J. Hamid, J, et al: Failure of delayed hypersensitivity skin testing to predict postoperative sepsis and mortality. Br Med J Clin Res. 1982;1:851–853.Google Scholar
22. Bozzetti, F, Migliavacca, S. Gallus, G. et al: “Nutritional” markers as prognostic indicators of postoperative sepsis in cancer patients. JPEN J Parenter Enteral Nutr. 1985;9:464–170.Google Scholar
23. Nazari, S. Dionigi, R, Comodi, I, et al: Preoperative prediction and quantification of septic risk caused by malnutrition. Arch Surg 1982;117:266–273.CrossRefGoogle ScholarPubMed
24. Craven, DE, Kunches, LM. Lichtenberg, DA. et al: Nosocomial infection and fatality in medical and surgical intensive care unit patients. Arch Intern Med. 1988;148:1161–1168.Google Scholar
25. Saviteer, SM, Samsa, GP, Rutala, WA: Nosocomial infections in the elderly, increased risk per hospital day. Am J Med. 1988;84:661–666.Google Scholar
26. Centers for Disease Control: Guideline for Prevention of Catheter-Associated Urinary Tract infectious, US Dept of Health, Education and Welfare, Atlanta. Centers for Disease Control. 1982.Google Scholar
27. Centers for Disease Control: Guideline for Prevention of Nosocomial Pneumonia. US Dept of Health, Education and Welfare. Atlanta. Centers for Disease Control, 1982.Google Scholar
28. Centers for Disease Control: Guideline for Prevention of intravenous Therapy-Related Infections and Guideline for Prevention of infections Related to Intravascular Pressure-Monitoring System, US Dept of Health, Education and Welfare. Atlanta. Centers for Disease Control. 1981.Google Scholar
29. Centers for Disease Control: Guideline for Prevention of Surgical Wound Infections, US Dept of Health. Education and Welfare publication No PB85-9234O3. Atlanta. Centers for Disease Control, 1985.Google Scholar
30. Wenzel, RP: Surveillance, in Mandell, GL, Douglas, RC Jr, Bennett, JF (eds): Principles and Practice of Intectious Diseases, ed 2. New York, John Wiley and Sons. 1985, pp 1604–1608.Google Scholar
31. Centers for Disease Control: Outline for Surveillance and Control of Nosocomial injections. US Dept of Health, Education and Welfare Atlanta, Centers for Disease Control, 1974.Google Scholar
32. Gorse, GJ, Messner, RL: Improved pressure sore healing with hydro-colloid dressings. Arch Dermatol. 1987;123:766–771.Google Scholar
33. Seltzer, MH, Bastidas, JA. Cooper, DM. et al: Instant nutritional assessment. JPEN J Parenter Enteral Natr 1979;3:157–159.CrossRefGoogle ScholarPubMed
34. Seltzer, MH, Slocum, BA. Cataldi-Botcher, EL, et al: Instant nutritional assessment: Absolute weight loss and surgical mortality. JPEN Parenter Enteral Nutr. 1982;6:218–220.Google Scholar
35. Seltzer, MH, Fletcher, HS, Slocum, BA, et al: Instant nutritional assessment in the intensive care unit. JPEN J Parenter Enteral Nutr. 1981;5:70–72.Google Scholar
36. Kaminsky, MV, Jeejeebhoy, KN: Modern clinical nutrition, part 1: Nutritional assessment-diagnosis of malnutrition and selection of therapy. Amrican Journal of intravenous Therapy and Clinical Nutrition. 1979;6:31–50.Google Scholar
37. Blackburn, GL, Thornton, PA: Nutritional assessment of the hospitalized patient. Med Clin North Am. 1979;63:1103–1115.Google Scholar
38. Kleinbaum, DG, Kupper, LL. Morgenstern, H: Matching in Epidemiologic Studies: Epidemiologic Research. Principles and Quantitative Methods. Belmont, Calif. Lifetime Learning Publications, 1982, pp 377–397.Google Scholar
39. SAS Institute Inc: The DISCRIM procedure, in SAS/STAT™-Guide for Personal Computers. Version 6 Edition. Cary. NC, SAS Institute Inc, 1985, pp 83–110.Google Scholar