Background: Catheter-related bloodstream infections (CRBSI) represent approximately 15% of healthcare-associated infections and up to 40% of nosocomial bacteremia cases.In-line filters are widely employed to remove particles, air, and microorganisms from infusion lines.However, their effectiveness in preventing infections remains uncertain.This study evaluated the association between in-line filter use and CRBSI and identified risk factors in patients receiving parenteral nutrition (PN).Methods: We retrospectively reviewed adults who received PN at Mie University Hospital between June 2020 and May 2025.Patients 18 years or those receiving PN other than Elneopa, Fulcalic, or Bifreed were excluded.CRBSI rates were compared between patients with and without online filters.Chi-square and unpaired ttests were used to assess risk factors, and decision tree analysis examined predictor hierarchies.Results: Baseline characteristics were comparable between the groups among 862 patients.The incidence of CRBSI was reduced in patients who used in-line filters (p < 0.001).Prolonged PN infusion duration, absence of in-line filter use, and intensive care unit (ICU) admission were significant risk factors for CRBSI.Decision tree analysis identified in-line filter use, infusion duration, and ICU admission as key determinants, with ICU admission plus prolonged infusion forming the highest-risk branch. Conclusion:In-line filters were associated with reduced CRBSI, indicating potential benefit in preventing infusion-related contamination.However, ICU admission and prolonged infusion remained strong predictors, demonstrating that filters alone are insufficient in high-risk settings.Overall, filters may complement broader infection control measures, and further prospective studies are needed to confirm efficacy and cost-effectiveness.
Kato et al. (Sun,) studied this question.