title: Prevention of catheter-related infections by a new, catheter-restricted antibiotic filling technique.
abstract: Catheter-related infections pose a hazard to both humans and laboratory animals. The aim of this study was to develop a technique preventing bacterial colonization of intravascular catheters. In 27 dogs a total of 70 catheters were implanted. On an average catheters were used for 207 days. Three protocols were compared: (1) flushing the catheters with a heparinized solution; (2) filling only the catheter lumen with alpha-chymotrypsin solution (225 units/ml); (3) filling only the catheter lumen with a solution containing a mixture of the aminoglycoside antibiotic gentamicin (20 mg/ml) and chymotrypsin (225 units/ml). Catheter fillings were always withdrawn before catheter use. Catheter exit sites were all treated with povidone iodine ointment once a day. Body temperatures and weights were recorded, bacteriological and electron microscopical examinations of catheters performed. Without gentamicin filling all catheters were colonized after a few weeks. The dogs showed clinical signs of chronic bacteraemia. Gentamicin filling eradicated colonization. No further bacteraemia was observed. We conclude that filling only the catheter lumen with a concentrated solution of chymotrypsin and gentamicin, combined with measures to prevent infections via the subcutaneous catheter tunnel, is an effective and safe technique to prevent catheter-related infections.
authors.affiliation: Institute of Pathology, UKRV-Charlottenburg, Free University of Berlin, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Palm
authors.forename: W
authors.initials: W
authors.lastname: Boemke
authors.forename: D
authors.initials: D
authors.lastname: Bayerl
authors.forename: N
authors.initials: N
authors.lastname: Schnoy
authors.forename: N C
authors.initials: NC
authors.lastname: Juhr
authors.forename: H W
authors.initials: HW
authors.lastname: Reinhardt
mesh_terms: D000818:Animals; D001419:Bacteria / Q000302:isolation & purification / Q000648:ultrastructure; D001831:Body Temperature / Q000187:drug effects; D002408:Catheters, Indwelling; D002918:Chymotrypsin / Q000627:therapeutic use*; D004285:Dogs; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use*; D006493:Heparin / Q000627:therapeutic use*; D018805:Sepsis / Q000517:prevention & control*
chemical_list: D005839:Gentamicins; D006493:Heparin; D002918:Chymotrypsin