Antibiotic Lock Technique for Prevention of Cuffed Tunnel Catheter                     Associated Bacteremia

Pervez, Aslam; Ahmed, Mariam; Ram, Sunanda J.; Torres, Claudio; Work, Jack; Zaman, Fahim; Abreo, Kenneth

doi:10.1177/112972980200300305

Cited by 41 publications

(30 citation statements)

References 14 publications

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“…AMLs with gentamicin with heparin [69][70][71] or citrate [67,72] versus heparin were used in five of the 13 studies. In another two studies, AMLs with gentamicin with heparin were used; however, vancomycin [73] or cefazolin [74] was also added.…”

Section: B Preventing Contamination Of the Catheter Hubmentioning

confidence: 99%

Prevention of catheter-related bacteremia in children on hemodialysis: time for action

Stefanidis

2009

Pediatr Nephrol

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This editorial commentary discusses the strategies for prevention of catheter-related bacteremia (CRB) in children on hemodialysis, which is associated with high morbidity and the increase of hospital cost. There is evidence that the use of arteriovenous fistulae in children on hemodialysis is associated with lower infection rates. Therefore, the use of catheters in these patients should be decreased by improving arteriovenous fistulae use rates or by increasing peritoneal dialysis patient recruitment. However, despite the wide adoption of such policies, hemodialysis catheters are still being used in a significant number of cases. For these patients, implementation of effective strategies for preventing contamination of the catheter hub should be a priority. The appropriate recording and evaluation of CRB rates are important for assessing preventive policies. In addition, the successful management of a CRB is essential for preventing recurrence of bacteremia. Recently it was documented in a number of randomized clinical trials that antimicrobial lock solutions were effective for preventing CRB. It is suggested that the use of antimicrobial locks should be considered in children who are at high risk of developing CRB, with caution for their long-term use, because of the possibility of bacterial resistance. Now is the time for action, and all preventive steps should be performed simultaneously to minimize the risk of CRB.

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Section: B Preventing Contamination Of the Catheter Hubmentioning

confidence: 99%

Prevention of catheter-related bacteremia in children on hemodialysis: time for action

Stefanidis

2009

Pediatr Nephrol

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“…Numerous randomized, controlled trials (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), as well as meta-analyses of these studies (21)(22)(23)(24)(25), have been performed during the past decade to evaluate the benefit of anti-microbial lock solutions in chronic hemodialysis patients with TCCs. These studies have been heterogeneous in nature and used different antibiotics (gentamicin, minocycline, cefazolin, cefotaxime, vancomycin) and nonantibiotic (citrate, taurolidine, EDTA) anti-microbial lock solutions; however, they have all shown a significant decline of 50 to 100% in CRIs compared with standard heparin lock without antibiotics or other sterilizing solutions (3).…”

mentioning

confidence: 99%

Emergence of Gentamicin-Resistant Bacteremia in Hemodialysis Patients Receiving Gentamicin Lock Catheter Prophylaxis

Landry

Braden

Gobeille

et al. 2010

Clinical Journal of the American Society of Nephrology

137

105

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Results: Within the first year of the GHL protocol, our CRI rate decreased from 17 to 0.83 events per 1000 catheter-days. Beginning 6 months after initiation of the GHL protocol, febrile episodes occurred in 13 patients with coagulase-negative Staphylococcus bacteremia resistant to gentamicin. Over the 4 years of GHL use, an additional 10 patients developed 11 episodes of gentamicin-resistant CRI (including 7 with Enterococcus faecalis), in which there were 4 deaths, 2 cases of septic shock requiring intensive care unit admission, and 4 cases of endocarditis. Because of these events, the GHL protocol was discontinued at the end of 2006.Conclusions: Although the use of GHL effectively lowered the CRI rate in our dialysis population, gentamicin-resistant CRIs emerged within 6 months. Gentamicin-resistant infections are a serious complication of the long-term use of GHLs. Alternative nonantibiotic catheter locks may be preferable to decrease the incidence of CRIs without inducing resistant pathogens.

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“…72,[83][84][85][86][87][88][89][90][91][92][93][94][95][96][97][98][99] The remaining six studies included citrate or taurolidine. [100][101][102][103][104][105]123 Most studies were conducted in patients undergoing haemodialysis (n = 17), but there were four studies in children with cancer.…”

Section: Resultsmentioning

confidence: 99%

Accuracy of bacterial DNA testing for central venous catheter-associated bloodstream infection in children with cancer

Millar

Zhou²,

Skinner³

et al. 2011

Health Technol Assess

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Antibiotic Lock Technique for Prevention of Cuffed Tunnel Catheter Associated Bacteremia

Abstract: 1) Tricitrasol and gentamicin as an antibiotic lock reduced the incidence of catheter associated bacteremia; 2) Covering the catheter hub with a sterile bag did not provide an additional advantage; 3) The antibiotic lock improved overall survival of catheters.

Cited by 41 publications

References 14 publications

Prevention of catheter-related bacteremia in children on hemodialysis: time for action

Prevention of catheter-related bacteremia in children on hemodialysis: time for action

Emergence of Gentamicin-Resistant Bacteremia in Hemodialysis Patients Receiving Gentamicin Lock Catheter Prophylaxis

Accuracy of bacterial DNA testing for central venous catheter-associated bloodstream infection in children with cancer

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