Vancomycin-lock therapy for prevention of catheter-related bloodstream infection in very low body weight infants

Abstract

Background: This study was to evaluate the effectiveness and safety of vancomycin- lock therapy for the prevention of catheter-related bloodstream infection (CRBSI) in very low body weight (VLBW) preterm infant patients.Methods: One hundred and thirty-seven cases of VLBW preterm infants who retained peripherally inserted central catheters (PICCs) were retrospectively reviewed, including 68 treating with heparin plus vancomycin (vancomycin-lock group) and 69 with heparin only (control group). The incidence of CRBSI, related pathogenic bacteria, adverse events during the treatment, complications, antibiotic exposure, PICC usage time, hospital stay, etc. were compared between the above two groups.Results: The incidence rate of CRBSI in the vancomycin-lock group (4.4%, 3/68) was significantly less than in the control group (21.7%, 15/69, p=0.004). Total antibiotic exposure time during the whole observation period was significantly shorter in the group than in the control group (11.2±10.0 vs 23.6±16.1 d; p<0.001). No hypoglycemia occurred during the locking, and the blood concentrations of vancomycin were not detectable.Conclusions: Vancomycin-lock may effectively prevent CRBSI in Chinese VLBW preterm infants, prolong the usage time of PICC line, and reduce the exposure time of antibiotics, without causing obvious side complications.

Risk Factors and Clinical Analysis for PICC Related Fungal Colonization in Premature Infants

“…Peripherally inserted central catheters (PICCs) are widely used in neonatal intensive care units (NICUs), especially for the treatment of extremely preterm infants and very low birth weight (VLBW) infants to provide secure venous access or safe administration of hyperosmolar solutions [1] . However, the use of PICCs increases the risk of catheter-related bloodstream infection (CRBSI), one of the most common nosocomial infections related to PICCs [2,3] .…”

“…However, the use of PICCs increases the risk of catheter-related bloodstream infection (CRBSI), one of the most common nosocomial infections related to PICCs [2,3] . CRBSI was associated with several lifethreatening complications, including necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP), extended the hospital stay and the increased mortality or morbidity of premature infants [1,4] . It have been reported that bacteria were the most important pathogen of CRBSI [5] .…”