Daptomycin antibiotic lock therapy for hemodialysis patients with Gram-positive bloodstream infections following use of tunneled, cuffed hemodialysis catheters: retrospective single center analysis

2015 ◽  
Vol 20 (2) ◽  
pp. 315-320 ◽  
Author(s):  
Hung-Wen Yen ◽  
Wu-Chang Yang ◽  
Der-Cherng Tarng ◽  
Chih-Yu Yang ◽  
Chiao-Lin Chuang ◽  
...  
Keyword(s):  
Bloodstream Infections ◽  
Hemodialysis Patients ◽  
Single Center ◽  
Gram Positive ◽  
Lock Therapy ◽  
Antibiotic Lock

scholarly journals High-Dose Daptomycin Is Effective as an Antibiotic Lock Therapy in a Rabbit Model of Staphylococcus epidermidis Catheter-Related Infection

2017 ◽  
Vol 62 (2) ◽  
Author(s):  
Jana Basas ◽  
Marta Palau ◽  
Carlos Ratia ◽  
José L. del Pozo ◽  
María Teresa Martín-Gómez ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Rabbit Model ◽  
Bloodstream Infections ◽  
High Dose ◽  
Coagulase Negative Staphylococci ◽  
Poor Patient ◽  
Lock Therapy ◽  
Antibiotic Lock ◽  
High Treatment

ABSTRACT Long-term catheter-related bloodstream infections (CRBSIs) involving coagulase-negative staphylococci are associated with poor patient outcomes, increased hospitalization, and high treatment costs. The use of vancomycin lock therapy has been an important step forward in treatment of these biofilms, although failures occur in 20% of patients. In this study, we report that a high dose of daptomycin lock therapy may offer a therapeutic advantage for these CRBSIs in just 24 h of treatment.

Role of Antibiotic Lock Therapy for the Treatment of Catheter-Related Bloodstream Infections

2009 ◽  
Vol 32 (9) ◽  
pp. 678-688 ◽  
Author(s):  
Jose L Del Pozo
Keyword(s):  
Antimicrobial Agents ◽  
Therapeutic Option ◽  
Bloodstream Infections ◽  
Resistance Pattern ◽  
Published Data ◽  
Sufficient Power ◽  
Lock Therapy ◽  
Antibiotic Lock ◽  
The Stability ◽  
Systemic Antibiotics

Catheter-related bloodstream infections are often difficult to treat because they are caused by organisms that embed themselves in a bio film layer on the catheter surface, resulting in an increased resistance to antimicrobial agents. Systemic antibiotics are usually administered but, although generally effective in eliminating circulating bacteria, they frequently fail to sterilize the line, leaving the patient at a continuing risk of complications or recurrence. A successful approach to managing these infections requires making an appropriate decision regarding whether the catheter should be removed or retained using antibiotic lock therapy; and choosing the type and duration of antimicrobial therapy based on the type of organism and its resistance pattern. Studies that have evaluated antibiotic lock therapy have varied in the types of antibiotics and concentrations used, the addition of heparin to the solutions, and dwell times in the catheter lumen. Guidelines from the Infectious Diseases Society of America include use of antibiotic lock therapy as a therapeutic option for intraluminal infections when the device is not removed and, although not routine, as prophylaxis for catheter-related infection in select patient populations. However, there are no published guidelines on the concentration of heparin or antibiotics that should be used, and minimal published data on the stability of heparin combinations with antibiotics. It is to be hoped that antibiotic locks will be subject to randomized controlled trials of sufficient power to confirm or refute their use.

scholarly journals 2117. Catheter-related Bacteremia in Hemodialysis Patients on Antibiotic Lock Therapy: Are Antibiotic Locks Ineffective?

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S621-S621
Author(s):  
Amar Krishna ◽  
Bhagyashri Navalkele ◽  
Suganya Chandramohan ◽  
Teena Chopra
Keyword(s):  
Hemodialysis Patients ◽  
Lock Therapy ◽  
Antibiotic Lock

The Efficacy of Alcohol-Antibiotic Lock Therapy for Treatment of Catheter Related Bloodstream Infections in Patients Receiving Home Parenteral Nutrition

2015 ◽  
Vol 86 (12) ◽  
Author(s):  
Michał ławiński ◽  
Krystyna Majewska ◽  
Iwona Fołtyn ◽  
Aleksandra Gradowska
Keyword(s):  
Gastrointestinal Tract ◽  
Parenteral Nutrition ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Home Parenteral Nutrition ◽  
First Episode ◽  
High Concentration ◽  
Lock Therapy ◽  
Antibiotic Lock ◽  
Catheter Replacement

AbstractIn patients with chronic gastrointestinal tract failure, requiring access to the venous system, the subsequent catheter re-insertion are leading to large veins thrombosis impeding or preventing the insertion of another catheter and exposing patients to the risk of complications. Understanding the pathophysiology of catheter-related infections, enabled to use methods allowing to eradicate the source of infection without removal and replacement of central catheter with a new one. In our center, for many years we have been using an alternative method involving implementation of the alcohol-antibiotic lock in the treatment of infections. This method is based on the assumption that the destruction of biofilm with concentrated alcohol will enable antibiotic penetration and killing other microorganisms. Treatment with alcohol-antibiotic lock lasts from 8 to 10 days and involves filling the catheter with 96% alcohol followed by a solution of the antibiotic of high concentration.of the study was to evaluate the efficacy of treatment of catheter-related bloodstream infections with two methods (catheter replacement with a new one and the alcohol-antibiotic lock therapy) in patients receiving home parenteral nutrition (HPN).. 428 HPN in the period from 1 January 2005 to 31 December 2010. Among which 240 (56%) of women with an average age of 56.5±16 years and 188 (44%) of men with an average age of 54±17 years. The indications to HPN were as follows: short bowel syndrome in 298 (70%) patients, multilevel obstruction of the gastrointestinal tract in 52 (12%), postoperative gastrointestinal fistulas in 48 (11.2%), malabsorption syndrome in 17 (4%), motility disorders in 6, cachexia in 4 and radiation enteritis in 3 patients.. In 247 (57.5%) from 428 patients, no episode of catheter-related bloodstream infection was found, while 181 were diagnosed with 352 episodes of catheter-related bloodstream infections. In 40 (9.4%) from 428 patients, 168 (47.8%) episodes have been found - almost a half. The mean duration of treatment of patients receiving home parenteral nutrition, starting from the first episode of catheterrelated bloodstream infection, in 48 patients treated with the lock was equal to 1053+748 days, and in 133 patients treated with catheter replacement was equal to 952+709 days (t-test p = 0.62).. The survival time of patients treated with alcohol-antibiotic lock is the same as in patients treated with the catheter removal and insertion of the new one. The use of alcohol-antibiotic lock to treat catheter-related bloodstream infections in order to eradicate selected microorganisms that colonize the lumen and cause an infection, is as effective as catheter replacement with a new one.

scholarly journals Efficacy of Antimicrobial Lock Solutionsagainst Catheter-Related Infections in Hemodialysis Patients

2021 ◽  
Vol 13 (4) ◽  
pp. 72
Author(s):  
Maria Skoulatou ◽  
Victoria Alikari ◽  
Georgia Toulia ◽  
Anna Kavga ◽  
Ourania Govina ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Randomized Clinical Trials ◽  
Bloodstream Infections ◽  
Hemodialysis Patients ◽  
Catheter Removal ◽  
Effective Prevention ◽  
Catheter Survival ◽  
Catheter Exchange ◽  
Increased Risk ◽  
Lock Therapy

INTRODUCTION: Hemodialysis patientsare at increased risk of catheter-related bloodstream infections (CRBSI) and catheter thrombosis asdialysis requires regular access to blood circulation through catheters. Antimicrobial Locking Solutions (ALS) containing anticoagulants and antimicrobial agents (antibiotic/non-antibiotic) are used to seal catheters in order to prevent thrombosis and CRBSI. PURPOSE: The investigation of internationalclinical studies regarding the efficacy and safety of the various ALS treatments for CRBSI in hemodialysis patients (HD patients) comparing to conventional approaches such as heparin treatment or catheter removal. METHODOLOGY: The review included prospective or retrospective clinical studies, randomized clinical trials or cohort studies published since 2015. Publications were retrieved from the “Pubmed”, “Google Scholar” and “Elsevier” databases using ‘catheter’, ‘catheter removal’, ‘hemodialysis’ ‘bacteremia’, ‘antimicrobial lock therapy’as key words. RESULTS: 17 articles were found to meet the criteria for this systematic review. These studies investigated locking solutions containing various antibiotic (Cefazolin, Gentamicin, Vancomycin, Cotrimoxazole, Daptomycin, Trimethoprim) or/and non-antibiotic agents (Citrate, taurolidine, ethanol, urokinase, Cathasept) +/- anticoagulants, single or in various combinations. The main objective of these studies was to identify the efficacy of ALS with respect to CRBSI risk rates, catheter exchange rates and related adverse effects. CONCLUSIONS: Antimicrobial Locking Therapy appears significantly beneficial forHD patients as it reduces CRBSI risk and prolongs catheter survival at considerable rates, so it should be seriously considered for systematic useagainst catheter-related infections. Further researchis required to establish safe and effective prevention and therapeutic protocols as alternatives to catheter removal practices.

scholarly journals Activity of Daptomycin with or without 25 Percent Ethanol Compared to Combinations of Minocycline, EDTA, and 25 Percent Ethanol against Methicillin-Resistant Staphylococcus aureus Isolates Embedded in Biofilm

2013 ◽  
Vol 57 (4) ◽  
pp. 1998-2000 ◽  
Author(s):  
R. Estes ◽  
J. Theusch ◽  
A. Beck ◽  
D. Pitrak ◽  
Kathleen M. Mullane
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Bloodstream Infections ◽  
Central Line ◽  
Methicillin Resistant ◽  
Content Type ◽  
Lock Therapy ◽  
Antibiotic Lock ◽  
Mrsa Colonization

ABSTRACTCentral venous catheters commonly develop central line-associated bloodstream infections.In vitroantibiotic lock therapy (ALT) was simulated on 10 methicillin-resistantStaphylococcus aureus(MRSA) clinical isolates imbedded in biofilm-coated silicon disks. Five days of 4-h daily exposures to daptomycin (2.5 mg/ml) in 25% ethanol or minocycline (3 mg/ml) plus 25% ethanol and 30 mg/ml EDTA resulted in significantly greater elimination of MRSA colonization than treatment with minocycline alone.

Bloodstream infections and patient survival with tunneled-cuffed catheters for hemodialysis: A single-center observational study

2020 ◽  
Vol 43 (12) ◽  
pp. 767-773
Author(s):  
Gabriele Donati ◽  
Alessandra Spazzoli ◽  
Anna Laura Croci Chiocchini ◽  
Anna Scrivo ◽  
Paolo Bruno ◽  
...  
Keyword(s):  
Risk Factors ◽  
Incidence Rate ◽  
Bloodstream Infection ◽  
Reference Value ◽  
Bloodstream Infections ◽  
Arterial Disease ◽  
Hemodialysis Patients ◽  
Systemic Antibiotic Therapy ◽  
Lock Therapy ◽  
Catheter Lock

Background: In hemodialysis patients, a tunneled-cuffed permanent catheter is mandatory when the arteriovenous fistula is not feasible. The major risks of the use of tunneled-cuffed permanent catheter are bloodstream infections. The aim of this study is to analyze bloodstream infections from tunneled-cuffed permanent catheter in hemodialysis patients. Methods: An observational prospective study was carried out and 79 hemodialysis patients with tunneled-cuffed permanent catheter were enrolled. Patients were divided into those with bloodstream infections from tunneled-cuffed permanent catheter and those without. Their clinical and laboratory characteristics were compared. An original tunneled-cuffed permanent catheter lock therapy sequence was carried out combined with systemic antibiotic therapy. In case of antibiotic resistance, the tunneled-cuffed permanent catheter was removed. Results: The patients affected by bloodstream infections from tunneled-cuffed permanent catheter were 16/79 (20.3%). The bloodstream infection from tunneled-cuffed permanent catheter’s incidence rate was 0.52 per 1000 catheter days. Twenty-three bloodstream infections from tunneled-cuffed permanent catheter were found in 16/79 patients who used tunneled-cuffed permanent catheter. Staphylococcus aureus was the cause of bloodstream infection from tunneled-cuffed permanent catheter in 35% of the cases and Staphylococcus epidermidis in 30% of the cases. Risk factors were infection located in other organs and the presence of peripheral obstructive arterial disease. Conclusion: The enrolled cohort showed a reduced bloodstream infection from tunneled-cuffed permanent catheter incidence rate in comparison with the reference value (1 per 1000 catheter days). To reduce the number of bloodstream infections from tunneled-cuffed permanent catheter, hand hygiene and asepsis management of the tunneled-cuffed permanent catheter during the connection to the extracorporeal circuit and an original tunneled-cuffed permanent catheter lock therapy sequence seem to be the most efficient measures. Infections of other organs and the presence of peripheral obstructive arterial disease are the most important risk factors for bloodstream infections from tunneled-cuffed permanent catheter.

Sign in / Sign up

Export Citation Format

Share Document