scholarly journals Impact of Different Catheter Lock Strategies on Bacterial Colonization of Permanent Central Venous Hemodialysis Catheters

2013 ◽  
Vol 34 (12) ◽  
pp. 1314-1317 ◽  
Author(s):  
Stefan Erb ◽  
Andreas F. Widmer ◽  
Sarah Tschudin-Sutter ◽  
Ursula Neff ◽  
Manuela Fischer ◽  
...  
Keyword(s):  
Sodium Chloride ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Bacterial Colonization ◽  
Hemodialysis Patients ◽  
Central Venous Catheters ◽  
Catheter Colonization ◽  
Central Venous ◽  
Lock Solution ◽  
Catheter Lock

Thirty-nine hemodialysis patients with permanent central venous catheters were analyzed for bacterial catheter colonization comparing different catheter-lock strategies. The closed needleless Tego connector with sodium chloride lock solution was significantly more frequently colonized with bacteria than the standard catheter caps with antimicrobially active citrate lock solution (odds ratio, 0.22 [95% confidence interval, 0.07–0.71]; P = .011).

Salvage of Long-Term Central Venous Catheters During an Outbreak ofPseudomonas putidaandStenotrophomonas maltophiliaInfections Associated With Contaminated Heparin Catheter-Lock Solution

2008 ◽  
Vol 29 (2) ◽  
pp. 125-130 ◽  
Author(s):  
M. Beatriz Souza Dias ◽  
Alina Bernardes Habert ◽  
Vera Borrasca ◽  
Valeska Stempliuk ◽  
Aina Ciolli ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Central Venous Catheters ◽  
High Response Rate ◽  
Care Hospital ◽  
Central Venous ◽  
Blood Samples ◽  
Asymptomatic Patients ◽  
Lock Solution ◽  
Catheter Lock

Objective.To describe the management of patients with long-term central venous catheters (CVCs) during an outbreak of infection due toPseudomonas putidaandStenotrophomonas maltophiliaassociated with contaminated heparin catheter-lock solution.Design.Descriptive study.Setting.Private, 250-bed tertiary-care hospital.Methods.In March 2003, we identified 2 febrile cancer patients withP. putidabacteremia. Over 2 days, 7 cases of bacteremia were identified; lots of syringes prefilled with heparin catheter-lock solution, supplied by a compounding pharmacy, were recalled and samples were cultured. More cases of bacteremia appeared during the following days, and any patient who had had a catheter lock infused with the suspect solution was asked to provide blood samples for culture, even if the patient was asymptomatic. Isolates that were recovered from culture were typed by pulsed-field gel electrophoresis. Antimicrobial salvage treatment of long-term CVCs was attempted.Results.A total of 154 patients had had their catheter lock infused with solution from the lots that were suspected of being contaminated. Only 48 of these patients had CVCs. By day 7 of the outbreak, 18 of these patients had become symptomatic. Twenty-six of the remaining 30 asymptomatic patients then also provided blood samples for culture, 10 of whom developed fever shortly after samples were collected. Thirty-two patients were identified who hadP. putidabacteremia; 9 also had infection due toS. maltophilia. Samples from 1 of the 3 lots of prefilled syringes in use at the time of the outbreak also grewP. putidaon culture. Molecular typing identified 3 different clones ofP. putidafrom patients and heparin catheter-lock solution, and 1 clone ofS. maltophilia. A total of 27 patients received antimicrobial therapy regimens, some of which included decontamination of the catheter lock with anti-infective lock solution. Of 27 patients, 19 (70%) retained their long-term CVC during the 6-month follow-up period.Conclusions.To our knowledge, this is one of the largest prospective experiences in the management of bloodstream infection associated with long-term CVCs. The infections were caused by gram-negative bacilli and were managed without catheter removal, with a high response rate. We emphasize the risks of using intravenous formulations of medications supplied by compounding pharmacies that produce large quantities of drugs.

scholarly journals Age and multimorbidities as poor prognostic factors for COVID-19 in hemodialysis: a Lebanese national study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mabel Aoun ◽  
Rabab Khalil ◽  
Walid Mahfoud ◽  
Haytham Fatfat ◽  
Line Bou Khalil ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Coronary Artery Disease ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Death Rate ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
National Study ◽  
Artery Disease

Abstract Background Hemodialysis patients with COVID-19 have been reported to be at higher risk for death than the general population. Several prognostic factors have been identified in the studies from Asian, European or American countries. This is the first national Lebanese study assessing the factors associated with SARS-CoV-2 mortality in hemodialysis patients. Methods This is an observational study that included all chronic hemodialysis patients in Lebanon who were tested positive for SARS-CoV-2 from 31st March to 1st November 2020. Data on demographics, comorbidities, admission to hospital and outcome were collected retrospectively from the patients’ medical records. A binary logistic regression analysis was performed to assess risk factors for mortality. Results A total of 231 patients were included. Mean age was 61.46 ± 13.99 years with a sex ratio of 128 males to 103 females. Around half of the patients were diabetics, 79.2% presented with fever. A total of 115 patients were admitted to the hospital, 59% of them within the first day of diagnosis. Hypoxia was the major reason for hospitalization. Death rate was 23.8% after a median duration of 6 (IQR, 2 to 10) days. Adjusted regression analysis showed a higher risk for death among older patients (odds ratio = 1.038; 95% confidence interval: 1.013, 1.065), patients with heart failure (odds ratio = 4.42; 95% confidence interval: 2.06, 9.49), coronary artery disease (odds ratio = 3.27; 95% confidence interval: 1.69, 6.30), multimorbidities (odds ratio = 1.593; 95% confidence interval: 1.247, 2.036), fever (odds ratio = 6.66; 95% confidence interval: 1.94, 27.81), CRP above 100 mg/L (odds ratio = 4.76; 95% confidence interval: 1.48, 15.30), and pneumonia (odds ratio = 19.18; 95% confidence interval: 6.47, 56.83). Conclusions This national study identified older age, coronary artery disease, heart failure, multimorbidities, fever and pneumonia as risk factors for death in patients with COVID-19 on chronic hemodialysis. The death rate was comparable to other countries and estimated at 23.8%.

Management of central venous catheters in pediatric onco-hematology using 0.9% sodium chloride and positive-pressure-valve needleless connector

2014 ◽  
Vol 18 (4) ◽  
pp. 393-396 ◽  
Author(s):  
Sara Buchini ◽  
Sara Scarsini ◽  
Marcella Montico ◽  
Roberto Buzzetti ◽  
Luca Ronfani ◽  
...  
Keyword(s):  
Sodium Chloride ◽  
Central Venous Catheters ◽  
Positive Pressure ◽  
Central Venous ◽  
Needleless Connector

Prospective Randomized Trial of 3 Antiseptic Solutions for Prevention of Catheter Colonization in an Intensive Care Unit for Adult Patients

2008 ◽  
Vol 29 (9) ◽  
pp. 847-853 ◽  
Author(s):  
J. Vallés ◽  
I. Fernández ◽  
D. Alcaraz ◽  
E. Chacón ◽  
A. Cazorla ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Relative Risk ◽  
Confidence Interval ◽  
Chlorhexidine Gluconate ◽  
Catheter Colonization ◽  
Central Venous ◽  
Gram Positive Bacteria ◽  
Skin Antisepsis ◽  
Antiseptic Solutions

Objective.To compare the effectiveness for prevention of central venous and arterial catheter colonization of 3 skin antisepsis with 1 of 3 antiseptic solutions: 10% aqueous povidone iodine (aqueous PI), 2% aqueous chlorhexidine gluconate (aqueous CG), and 0.5% alcoholic chlorhexidine gluconate (alcoholic CG).Design.Prospective, randomized controlled trial.Setting.Intensive care unit in a teaching hospital.Methods.Patients were randomly assigned to 1 of the 3 skin antisepsis groups. The distal tips of catheters were semiquantitatively cultured when the catheters were no longer necessary or if there was a suspicion of catheter-related infection. Rates of catheter colonization, catheter-related sepsis, and catheter-related bacteremia were compared among the 3 groups.Results.A total of 631 catheters were included in the study (194 from the aqueous PI group, 211 from the aqueous CG group, and 226 from the alcoholic CG group). The incidence of catheter colonization was significantly lower in the alcoholic CG than in the aqueous PI group (14.2% vs 24.7%; relative risk, 0.5 [95% confidence interval, 0.3-0.8; P < .01]); it was also significantly lower in the aqueous CG group than in the aqueous PI group (16.1 % vs 24.7%; relative risk, 0.6 [95% confidence interval, 0.4-0.9; P = .03]). There were no significant differences between the aqueous CG and the alcoholic CG groups. Incidences of catheter-related bacteremia were similar for all 3 groups. The aqueous and alcoholic CG solutions were superior to the aqueous PI solution in preventing catheter colonization due to gram-positive bacteria.Conclusions.The aqueous and alcoholic CG solutions for cutaneous antisepsis were similarly effective in preventing colonization of central venous catheters and arterial catheters. Both had significantly lower incidences of colonization than did the aqueous PI solution; this effect seems to be related to the CG solutions' more efficacious prevention of colonization with gram-positive bacteria.

Sign in / Sign up

Export Citation Format

Share Document