Successful Prevention of Cuffed Hemodialysis Catheter-Related Infection Using an Antibiotic Lock Technique by Strictly Catheter-Restricted Antibiotic Lock Solution Method

2009 ◽  
Vol 27 (2) ◽  
pp. 206-211 ◽  
Author(s):  
Ping Zhang ◽  
Jing Yuan ◽  
Huizhen Tan ◽  
Rong Lv ◽  
Jianghua Chen
Keyword(s):  
Solution Method ◽  
Catheter Related Infection ◽  
Hemodialysis Catheter ◽  
Lock Solution ◽  
Antibiotic Lock ◽  
Successful Prevention ◽  
Antibiotic Lock Technique

scholarly journals Salvage of Hemodialysis Catheter in Staphylococcal Bacteremia: Case Series, Revisiting the Literature, and the Role of the Pharmacist

2018 ◽  
Vol 8 (2) ◽  
pp. 121-129 ◽  
Author(s):  
Wasim S. El Nekidy ◽  
Derrick Soong ◽  
Albert Kadri ◽  
Osama Tabbara ◽  
Amina Ibrahim ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Case Series ◽  
Blood Stream ◽  
Hemodialysis Patients ◽  
Vascular Trauma ◽  
Central Vein ◽  
Hemodialysis Catheter ◽  
Lock Solution ◽  
Antibiotic Lock ◽  
Systemic Antibiotics

Catheter-related blood stream infections comprise a major concern in hemodialysis patients, leading to increased mortality, morbidity, and cost of treatment. Prompt appropriate systemic antibiotics treatment, which includes administration of appropriate systemic antibiotics and, frequently, catheter removal and replacement, is warranted. However, in hemodialysis patients, repeated catheter insertions may cause central vein stenosis and thrombosis which limits the future availability of hemodialysis access. Lock solutions containing antibiotics and anticoagulants, instilled directly into the catheter lumen after each dialysis, have been successfully utilized for catheter salvage but higher rates of recurrence and complications were observed in infections resulting from staphylococcal species. We report several cases of catheter salvage using antibiotic lock solution in staphylococcal bacteremia with the purpose of stimulating the interest in randomized clinical trials. Evaluating the risk and benefits of catheter salvage in this patient subset in light of optimized systemic antibiotic dosing, improved lock solution use, and multidisciplinary involvement, balanced with the critical need to prevent unnecessary vascular trauma, is of great importance.

Management of hemodialysis catheter related bacteremia (CRB) with an adjunctive antibiotic lock solution

2001 ◽  
Vol 37 (4) ◽  
pp. A21
Author(s):  
Zipporah Krishnasami ◽  
Donna Carlton ◽  
Lisa Bimbo ◽  
Michael Allon
Keyword(s):  
Hemodialysis Catheter ◽  
Lock Solution ◽  
Antibiotic Lock

scholarly journals Randomized, Double-Blind Trial of an Antibiotic-Lock Technique for Prevention of Gram-Positive Central Venous Catheter-Related Infection in Neutropenic Patients with Cancer

1999 ◽  
Vol 43 (9) ◽  
pp. 2200-2204 ◽  
Author(s):  
Jordi Carratalà ◽  
Jordi Niubó ◽  
Alberto Fernández-Sevilla ◽  
Eulalia Juvé ◽  
Xavier Castellsagué ◽  
...  
Keyword(s):  
Hematologic Malignancy ◽  
Insertion Site ◽  
Central Venous ◽  
Gram Positive ◽  
Catheter Related Infection ◽  
Gram Positive Bacteria ◽  
Staphylococcus Capitis ◽  
Neutropenic Patients ◽  
Antibiotic Lock ◽  
Antibiotic Lock Technique

ABSTRACT The aim of the present study was to determine the efficacy of an antibiotic-lock technique in preventing endoluminal catheter-related infection with gram-positive bacteria in neutropenic patients with hematologic malignancies. Patients with nontunneled, multilumen central venous catheters were assigned in a randomized, double-blinded manner to receive either 10 U of heparin per ml (57 patients) or 10 U of heparin per ml and 25 μg of vancomycin per ml (60 patients), which were instilled in the catheter lumen and which were allowed to dwell in the catheter lumen for 1 h every 2 days. Insertion-site and hub swabs were taken twice weekly. The primary and secondary end points of the trial were significant colonization of the catheter hub and catheter-related bacteremia, respectively. Significant colonization of the catheter hub occurred in nine (15.8%) patients receiving heparin (seven patients were colonized with Staphylococcus epidermidis, one patient was colonized with Staphylococcus capitis, and one patient was colonized withCorynebacterium sp.), whereas the catheter hubs of none of the patients receiving heparin and vancomycin were colonized (P = 0.001). Catheter-related bacteremia developed in four (7%) patients receiving heparin (three patients had S. epidermidis bacteremia and one patient had S. capitisbacteremia), whereas none of the patients in the heparin and vancomycin group had catheter-related bacteremia (P = 0.05). The times to catheter hub colonization and to catheter-related bacteremia by the Kaplan-Meier method were longer in patients receiving heparin and vancomycin than in patients receiving heparin alone (P = 0.004 and P = 0.06, respectively). Our study shows that a solution containing heparin and vancomycin administered by using an antibiotic-lock technique effectively prevents catheter hub colonization with gram-positive bacteria and subsequent bacteremia during chemotherapy-induced neutropenia in patients with hematologic malignancy.

scholarly journals Management of hemodialysis catheter-related bacteremia with an adjunctive antibiotic lock solution

2002 ◽  
Vol 61 (3) ◽  
pp. 1136-1142 ◽  
Author(s):  
Zipporah Krishnasami ◽  
Donna Carlton ◽  
Lisa Bimbo ◽  
Maria E. Taylor ◽  
Daniel F. Balkovetz ◽  
...  
Keyword(s):  
Hemodialysis Catheter ◽  
Lock Solution ◽  
Antibiotic Lock

Effect of Ethanol/Trisodium Citrate Lock on Microorganisms Causing Hemodialysis Catheter-Related Infections

2007 ◽  
Vol 8 (4) ◽  
pp. 262-267 ◽  
Author(s):  
T.A. Takla ◽  
S.A. Zelenitsky ◽  
L.M. Vercaigne
Keyword(s):  
In Vitro Study ◽  
Trisodium Citrate ◽  
Methicillin Resistant ◽  
Hemodialysis Catheter ◽  
E Coli ◽  
Lock Solution ◽  
Mueller Hinton ◽  
Mueller Hinton Broth ◽  
Made In

Purpose This in vitro study tested the effectiveness of a novel 30% ethanol/4% trisodium citrate (TSC) lock solution against the most common pathogens causing hemodialysis catheter-related infections. Methods Clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) (n=4), methicillin-sensitive S. aureus (MSSA) (n=8), methicillin-resistant Staphylococcus epidermidis (MRSE) (n=8), Pseudomonas aeruginosa (n=4) and Escherichia coli (n=4) were tested in duplicate. Bacterial suspensions of each isolate were made in a control solution of normal saline and Mueller-Hinton broth (MHB), and in a lock solution of ethanol 30%, TSC 4% and MHB. Suspensions were incubated at 37 °C for 48 h. Colony counts were determined from samples collected at t=0 h (before exposure to the ethanol/TSC lock), t=1 h (one hour after exposure to the ethanol/TSC lock), t=24 h and t=48 h. To confirm the absence of viable organisms in the lock solution, the remaining volume at 48 h was filtered through a 0.45 μm filter. The filter was rinsed with 15 mL sterile water and plated on tryptic soy agar (TSA). Results All controls demonstrated significant growth over 48 h. In the lock solutions, initial inocula were reduced to 0 viable colonies by t=1 h (6-log kill), and there was no growth at t=24 and 48 h. Filtering of lock solutions also showed no growth. These results were consistent among duplicates of all isolates. Conclusions The 30% ethanol/4% TSC lock solution consistently eradicated MRSA, MSSA, MRSE, P. aeruginosa and E. coli within 1 h of exposure. Experiments are currently underway to test this novel lock solution on preventing biofilm production by these pathogens.

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