A patient on parenteral support develops sepsis. What is the most likely cause?

In the context of a patient on parenteral support developing sepsis, bacterial translocation is often the most likely cause. Parenteral nutrition bypasses the normal gastrointestinal pathway, which can lead to alterations in gut health and flora. When the gut is not being used as it normally would be, there can be a breakdown of the intestinal barrier. This can result in the translocation of bacteria from the intestine into the bloodstream, triggering an immune response that can lead to sepsis.

Bacterial translocation is particularly relevant in patients receiving nutrition via intravenous routes, as their intestinal mucosa may deteriorate due to lack of stimulation from food intake, leading to increased permeability. As a consequence, pathogenic bacteria can enter the circulatory system, which can quickly result in a systemic infection.

The other options are important considerations in general clinical practice, but they are less directly implicated in the development of sepsis in this specific scenario. Contaminated feeding solutions can certainly contribute to infection if the solution is not handled or stored properly; however, bacterial translocation is a more common and specific concern associated with parenteral nutrition.

Dehydration and electrolyte imbalance are critical issues but are less likely to be direct causes of sepsis. They may contribute to overall patient