Use of a gentamicin‐citrate lock leads to lower catheter‐related bloodstream infection rates and reduced cost of care in hemodialysis patients

2020 ◽  
Author(s):  
Wael F. Hussein ◽  
Norma Gomez ◽  
Sumi J. Sun ◽  
Junhua Yu ◽  
Fang Yang ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Hemodialysis Patients ◽  
Cost Of Care ◽  
Infection Rates ◽  
Catheter Related Bloodstream Infection

A 2% taurolidine catheter lock solution prevents catheter-related bloodstream infection (CRBSI) and catheter dysfunction in hemodialysis patients

2021 ◽  
Vol 30 (14) ◽  
pp. S24-S32
Author(s):  
Matthias Alexander Neusser ◽  
Irina Bobe ◽  
Anne Hammermeister ◽  
Udo Wittmann
Keyword(s):  
Adverse Events ◽  
Bloodstream Infection ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Technical Problems ◽  
Hemodialysis Catheter ◽  
Catheter Dysfunction ◽  
Lock Solution ◽  
Catheter Lock ◽  
Catheter Related Bloodstream Infection

HIGHLIGHTS 2% taurolidine catheter lock solution without additives is safe and efficient. CRBSI and dysfunction rates compare favorably against other studies in hemodialysis Background: In hemodialysis patients, catheter-related bloodstream infection (CRBSI) and catheter dysfunction are common and cause significant morbidity, mortality, and costs. Catheter lock solutions reduce CRBSI and catheter dysfunction rates, but solutions containing heparin, citrate, or antibiotics are associated with adverse effects. Due to its antimicrobial and antithrombotic properties and benign safety profile, taurolidine is suitable for use in catheter lock solutions. In this study the effectiveness and safety of a catheter lock solution containing 2% taurolidine without citrate or heparin (TauroSept®, Geistlich Pharma AG, Wolhusen, Switzerland) in hemodialysis patients were investigated for the first time. Methods: Data from 21 patients receiving chronic hemodialysis via tunneled central venous catheters with 2% taurolidine solution as a catheter lock were analyzed in a single-center retrospective study and compared with the existing literature in a review. The primary endpoint was CRBSI rate. Secondary endpoints included catheter dysfunction, treatment, and costs; catheter technical problems, resolution, and costs; and adverse events. Data were compared to outcomes with standard lock solutions in the literature. Results: No CRBSIs occurred during the observation period of 5,639 catheter days. The catheter dysfunction rate was 0.71 per 1,000 catheter days, and the catheter dysfunction treatment costs were CHF (Swiss Franc) 543 per patient. No technical problems or adverse events related to the use of 2% taurolidine-containing catheter lock solution were observed. These results compare favorably with other catheter lock solutions. Conclusions: A solution containing 2% taurolidine seems suitable as a hemodialysis catheter lock. In a Swiss cohort, it prevented CRBSI, limited catheter dysfunction, and was cost-efficient.

A 2% Taurolidine Catheter Lock Solution Prevents Catheter-Related Bloodstream Infection (CRBSI) and Catheter Dysfunction in Hemodialysis Patients

2020 ◽  
Vol 25 (4) ◽  
pp. 48-56
Author(s):  
Matthias Alexander Neusser ◽  
Irina Bobe ◽  
Anne Hammermeister ◽  
Udo Wittmann
Keyword(s):  
Bloodstream Infection ◽  
Hemodialysis Patients ◽  
Catheter Dysfunction ◽  
Lock Solution ◽  
Catheter Lock ◽  
Catheter Related Bloodstream Infection

Highlights 2% Taurolidine catheter lock solution without additives is safe and efficient. CRBSI and dysfunction rates compare favorably against other studies in hemodialysis.

Increased Catheter-Related Bloodstream Infection Rates After the Introduction of a New Mechanical Valve Intravenous Access Port

2006 ◽  
Vol 27 (1) ◽  
pp. 67-70 ◽  
Author(s):  
Lisa L. Maragakis ◽  
Karen L. Bradley ◽  
Xiaoyan Song ◽  
Claire Beers ◽  
Marlene R. Miller ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Mechanical Valve ◽  
Positive Pressure ◽  
Infection Rates ◽  
Intravenous Catheter ◽  
Access Port ◽  
Intravenous Access ◽  
Mechanical Valves ◽  
Catheter Related Bloodstream Infection

The technology of intravenous catheter access ports has evolved from open ports covered by removable caps to more-sophisticated, closed versions containing mechanical valves. We report a significant increase in catheter-related bloodstream infections after the introduction of a new needle-free positive-pressure mechanical valve intravenous access port at our institution.

Central Catheter-related Bloodstream Infection Rates in Children on Home Parenteral Nutrition

2020 ◽  
Vol 70 (3) ◽  
pp. e59-e62
Author(s):  
Ivana Trivić ◽  
Zrinjka Mišak ◽  
Višnjica Kerman ◽  
Hrvoje Prlić ◽  
Sanja Kolaček ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Bloodstream Infection ◽  
Home Parenteral Nutrition ◽  
Central Catheter ◽  
Infection Rates ◽  
Catheter Related Bloodstream Infection

A 10-Year Review of a Vascular Access Service for Patients Receiving Hemodialysis: Analysis of Procedural Modifications and Service Innovations

2016 ◽  
Vol 21 (2) ◽  
pp. 93-102
Author(s):  
John F. Lancashire ◽  
Michael Steele ◽  
Amy Swinbank ◽  
Dianne Du Toit ◽  
Mark J. Jackson
Keyword(s):  
Bloodstream Infection ◽  
Patient Outcomes ◽  
Vascular Access ◽  
Hemodialysis Patients ◽  
Demographic Characteristics ◽  
Service Performance ◽  
Gold Coast ◽  
Infection Rates ◽  
Access Service ◽  
Arteriovenous Access

Abstract Objective: We aimed to identify trends in vascular access modalities for renal hemodialysis and to evaluate the influence of service modifications on service performance and patient outcomes. Methods: Retrospective analysis of incident and prevalent hemodialysis patients treated by the Gold Coast Hospital and Health Service, Queensland, Australia, between January 2004 and December 2013 was conducted. A comparison of patient demographic characteristics and analysis of trends in access modality and outcomes was performed for each group over the study period. Modifications to service structure and practice changes were also evaluated. Results: A total of 1787 patients (456 incident and 1331 prevalent) and 1671 procedures were examined. The proportion of patients starting hemodialysis on a catheter decreased from 79.2% to 63.6%. Patients starting hemodialysis on a fistula increased from 16.7% to a peak of 61.5% but fell to 27.3% in 2003. Catheter use in prevalent patients decreased from 11.7% to 6.1%, whilst fistula use increased from 60.6% to 88.5%. Graft access remained low for the incident group (0.0%–9.1%) and was reduced in prevalent patients from 27.7% to 4.9%. Bloodstream infection rates were reduced from 1.88 to 1.60 per 1000 dwelling-days. Endovascular and surgical revision of arteriovenous access was increased. Conclusions: Coordinated and multidisciplinary access service provided earlier referral for planned incident access with fewer catheters and increased fistulas with reduced bloodstream infection rates. Modifications to this vascular access service are associated with improved permanent access rates for incident and prevalent patients. There was an overall improvement of service performance and patient outcomes.

scholarly journals Mandated Self-reporting of Ventilator-Associated Pneumonia Bundle and Catheter-Related Bloodstream Infection Bundle Compliance and Infection Rates

JAMA Surgery ◽  
2014 ◽  
Vol 149 (10) ◽  
pp. 1003 ◽  
Author(s):  
Ryan A. Helmick ◽  
Meredith L. Knofsky ◽  
Carla C. Braxton ◽  
Anuradha Subramanian ◽  
Patricia Byers ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Ventilator Associated Pneumonia ◽  
Infection Rates ◽  
Bundle Compliance ◽  
Catheter Related Bloodstream Infection

Comparison of ethanol lock and heparin lock solution as prevention of catheter-related bloodstream infection in hemodialysis patients: systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 1 (1) ◽  
pp. 8-15
Author(s):  
Amy Rosalie ◽  
Made Angga Putra ◽  
Muhammad Rizki Bachtiar ◽  
David Hermawan Christian ◽  
Ivan Joalsen
Keyword(s):  
Randomized Controlled Trials ◽  
Bloodstream Infection ◽  
Vascular Access ◽  
Hemodialysis Patients ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Catheter Dysfunction ◽  
Ethanol Lock ◽  
Heparin Lock ◽  
Catheter Related Bloodstream Infection

Introduction: Catheter-related bloodstream infection (CRBSI) is a common complication of catheter use for vascular access in hemodialysis patients and a major cause of morbidity and mortality. Preventive measures, including antibiotic lock, are inadequate due to the risk of resistance and insufficient effect against bacterial biofilm. Ethanol, an antimicrobial substance, is a potential prophylactic lock-in preventing CRBSI. This study aims to assess ethanol lock's effectiveness in preventing CRBSI in hemodialysis patients with a catheter as vascular access and its impact on catheter dysfunction. Methods: Researchers systematically searched online databases including Pubmed, Cochrane Library, and Science Direct for relevant randomized controlled trials (RCTs) published within 2011 until 2020. Relevant data were pooled in PICOs (Population, Intervention, Control, Outcomes) format and analyzed with Review Manager (version 5.3.5, Cochrane Collaboration, Denmark). Results: Seven RCTs involving 453 patients were assessed. The primary outcome indicates that prophylactic ethanol lock significantly reduces the incidence of CRBSI compared to that of heparin lock (RR=0.32, 95% CI 0.12-0.83, p=0.02, heterogeneity I2=68%). The secondary outcome suggests no significant difference in the incidence of catheter dysfunction in ethanol lock and heparin lock (RR=0.75, 95% CI 0.23-2.40, p=0.63, heterogeneity I2=68%). Conclusion: Ethanol is a potential prophylactic lock agent in preventing CRBSI in hemodialysis patients with catheter access. Further research is needed to synchronize the procedural use of ethanol lock and evaluate its long-term effect.

scholarly journals Differences in Device-Associated Infections Rates in Argentina

2020 ◽  
Vol 41 (S1) ◽  
pp. s469-s469
Author(s):  
Wanda Cornistein ◽  
Griselda Almada ◽  
Andrea Novau ◽  
Viviana Rodriguez ◽  
Cristina Freuler ◽  
...  
Keyword(s):  
Infection Control ◽  
Bloodstream Infection ◽  
Surveillance System ◽  
National Surveillance ◽  
Infection Rates ◽  
Middle Income ◽  
Joint Commission International ◽  
Device Associated Infection ◽  
Catheter Related Bloodstream Infection ◽  
National Surveillance System

Background: Infection control programs (ICPs) are essential to reducing, in a progressive and sustained manner, healthcare-associated infections (HAIs). To achieve this goal these programs need not only resources (ie, trained human resources and financial resources) but also institutional leadership support. In our country, epidemiological surveillance is voluntary and is registered in the Argentina National Hospital Infection Surveillance System (VIHDA) where 114 hospitals and 78 adult intensive care unit (ICU) report their HAI rates. Many of these institutions do not have IPC or specific resources for this purpose. On the other hand, there are institutions with IPC, recognized by an international accreditation like Joint Commission International, that carry out an advanced and continuous program, with specific improvement goals for prevention and infection control. There is an imperative need in low- and middle-income countries to highlight the impact of ICPs in this setting and to promote regulations for mandatory surveillance and ICPs in all acute-care hospitals. Objective: To compare the rates for device-associated infections in ICUs of institutions with advanced ICPs versus national rates. Design: We conducted an observational, retrospective study, which includes device associated infection rates in adult critical care units from 2014 to 2018. We included all ICUs reporting to VIHDA and 3 surgical-medical teaching hospitals with an advanced ICP and Joint Commission International accreditation (Hospital Italiano de Buenos Aires, Hospital Universitario Austral, Hospital Aleman). The VIHDA definition was used to define central line-associated bloodstream infection (CLABSI), catheter-related urinary infection (CAUTI), and ventilator-associated pneumonia (VAP). The rates were compared as adjusted reasons for exposure time using openepi.com software provided by the CDC. Results: Device associated infection rates in hospitals with advanced ICPs and in hospitals in the national surveillance system in Argentina are shown in Table 1. Compliance with infection control measures and bundles for device-associated infections in the 3 hospitals with advanced ICPs was >80%. No data were available for the rest of hospitals included the national surveillance system. Conclusions: Lower infection-control rates, catheter-related bloodstream infection and VAP, are possible in a middle-income country like Argentina when resources are allocated for this purpose and hospital leadership reinforces the efforts. Notably, all 3 hospitals improved their rates over time. The differences in catheter-related bloodstream infection and VAP rates between these hospitals and the rest of the hospitals in our surveillance system was significant and highlights the need for support when it comes to implementing ICPs.Funding: NoneDisclosures: Wanda Cornistein reports fees for conferences not related to this topic from the following speaker’s bureaus: Pfizer, Merck, and Becton Dickinson.

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