The innate host defense system of the HPN patients in this study
appeared not to be affected by the administration of PN, in the absence of an active underlying disease and without the use of
medication that might affect immune function. However, the
presence of the venous access device, which per definition affects
the host defense by providing a direct connection between the
internal and external environment, has been identified as an
independent risk factor for the occurrence of bloodstream infec-
tions. 27 To decrease this risk for microorganism invasion through
the open connection, our HPN patients and medical staff are thor-
oughly trained in aseptic catheter management. In addition, based
on a randomized clinical trial, which presented a dramatic (>90%)
reduction in the occurrence of catheter-related bloodstream
infections (CRBSI), we recently (2008; i.e. >1 year before the start of
the present study) switched from low-dose (150 U/ml) heparin to
2% taurolidine (TauroSept ? ) catheter lock solution. 2,28