Taurolidine lock solution for catheter-related bloodstream infections in pediatric patients: A meta-analysis

Sun, Yan; Wan, Guanghui; Liang, Li‐Ping

doi:10.1371/journal.pone.0231110

Cited by 28 publications

(30 citation statements)

References 33 publications

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“…When assessing the efficacy of the tested substances, the values of their minimum inhibitory concentrations should be considered. Clinical studies published so far on the use of taurolidine as a catheter clock solution also confirm its effectiveness in reducing CRBSI [ 43 – 46 ]. Taurolidine concentration of 2% present in commercially available preparations exceeds several times the MIC50 value determined for different Gram-positive and Gram-negative bacteria (<512 mg/L).…”

Section: Discussionmentioning

confidence: 84%

Antimicrobial activity of hemodialysis catheter lock solutions in relation to other compounds with antiseptic properties

et al. 2021

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Proper protection of vascular access after haemodialysis is one of the key measures for the prevention of catheter-related infections. Various substances with bactericidal and anticoagulant properties are used to fill catheters, but due to the unsatisfactory clinical effects and occurrence of adverse reactions, the search for new substances is still ongoing. In the present paper, we compared the in vitro antimicrobial activity of solutions used for tunnelled catheter locking (taurolidine, trisodium citrate) and solutions of substances that could potentially be used for this purpose (sodium bicarbonate, polyhexanide-betaine). The studies have been conducted on bacteria that most commonly cause catheter-related infections. The values of both minimum inhibitory concentration and minimum biofilm eradication concentration of the substances were determined. The ability of the tested substances to eradicate biofilm from the dialysis catheter surface was also evaluated. The results showed that polyhexanide-betaine inhibited the growth of all microbes comparably to taurolidine, even after ≥ 32-fold dilution. The activity of trisodium citrate and sodium bicarbonate was significantly lower. Polyhexanide exhibited the highest activity in the eradication of bacterial biofilm on polystyrene plates. The biofilm formed on a polyurethane dialysis catheter was resistant to complete eradication by the test substances. Polyhexanide-betaine and taurolidine showed the highest activity. Inhibition of bacterial growth regardless of species was observed not only at the highest concentration of these compounds but also after dilution 32–128x (taurolidine) and 32–1024x (polyhexanide-betaine). Therefore, it can be assumed that taurolidine application as a locking solution prevents catheter colonization and systemic infection development. Taurolidine displays high antimicrobial efficacy against Gram-positive cocci as well as Gram-negative bacilli. On the contrary, the lowest antibacterial effect displayed product contained sodium bicarbonate. The inhibitions of bacterial growth were not satisfactory to consider it as a substance for colonization prevention. Polyhexanidine-betaine possessed potent inhibitory and biofilm eradication properties comparing to all tested products. PHMB is applied as a wound irrigation solution worldwide. However, based on our results, we assume that the PHMB is a promising substance for catheter locking solutions thanks to its safety and high antimicrobial properties.

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Section: Discussionmentioning

confidence: 84%

Antimicrobial activity of hemodialysis catheter lock solutions in relation to other compounds with antiseptic properties

et al. 2021

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“…Catheter removal and exchange is a common practice for the treatment ofCRBSI (Böhlke et al, 2015) which can be quite challenging for patients on regular catheterizations such as HD patients, cancer patients or patients on parenteral nutrition (Hachem et al, 2018). ALS treatment is considered promising for systematic application as it appears to have not only significant effect on CRBSI rates (Sun et al, 2020) but also presents other considerable advantages such as cost-effectiveness (Leistner et al, 2014;Winnicki et al,2017) and anti-biofilm properties. The microbial biofilm that is formed in the lumen of infected catheters is often resistant to systemic antibiotics, so biofilm prevention is essential for CRBSI treatment (Pérez-Granda et al, 2017;Wang et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Norris et al though, concluded that taurolidine is potentially beneficial against bloodstream infections in high risk cancer patients but further research is required for conclusive results (Norris et al, 2017). The more recent meta-analysis of Sun et al, for CRBSI risk in pediatric patients, reportsa significant reduction of CRBSI incidences with taurolidine locks but indicates that thequality of the studies included in their review was poor (Sun et al, 2020). No studies on taurolidine as a single antimicrobial agent in lock solutions specifically for HD patients were identified.…”

Section: Discussionmentioning

confidence: 99%

“…This view is corroborated by the review of Yahav et al (2008) who concluded that antibiotic catheter locks should be considered as a routine clinical practice.On the other hand, Rijnders et al (2018) and Bueloni et al (2019) in their studies with trimethoprimand gentamicin/cefazolin respectively did not detect measurable differencescomparing to non-antibiotic locks. These inconsistencies highlight the need for further research based on subgroup analysis and high quality clinical trials as most researchers point out in recent relevant reviews (Böhlke et al, 2015;Dang et al, 2019;Sun et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Non-antibiotic agents commonly used in ALS are sodium citrate, taurolidine, EDTA and ethanol (Arechabala, 2018;Dang et al, 2019). Prophylactic use of ALS combining anticoagulants with anti-microbials (antibiotic or non-antibiotic) has been associated with a significant reduction in CRBSI risk by 60%-70% (Böhlke et al, 2015;Sun et al, 2020). Moreover, ALS approaches present advantages such as reduced mortality, prevention of biofilm formation and broad range of antimicrobial activity, without risking catheter dysfunction or creation of resistant microbial strains (Raad et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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

Skoulatou¹,

Alikari²,

Toulia³

et al. 2021

GJHS

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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.

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Prophylactic antibiotics for preventing gram-positive infections associated with long-term central venous catheters in adults and children receiving treatment for cancer

Bosch

Woensel

Wetering

2021

Cochrane Database of Systematic Reviews

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Taurolidine lock solution for catheter-related bloodstream infections in pediatric patients: A meta-analysis

Cited by 28 publications

References 33 publications

Antimicrobial activity of hemodialysis catheter lock solutions in relation to other compounds with antiseptic properties

Antimicrobial activity of hemodialysis catheter lock solutions in relation to other compounds with antiseptic properties

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

Prophylactic antibiotics for preventing gram-positive infections associated with long-term central venous catheters in adults and children receiving treatment for cancer

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