Catheter lock solutions to prevent bloodstream infections in high-risk hemodialysis patients.
BACKGROUND
Antimicrobial catheter lock solutions (CLS) have been shown to prevent bacteremia in chronic hemodialysis (HD) patients with new HD catheters. However, there is little information regarding the usage of these solutions in patients who have a history of recurrent bacteremia and are at very high risk of infection. The purpose of this investigation was to identify the efficacy of these solutions in such high-risk patients.


METHODS
A retrospective chart review was performed to identify patients who had a history of recurrent bacteremia and had received prophylaxis with antimicrobial CLS.


RESULTS
Nine patients with recurrent bacteremia were identified. These patients had received prophylaxis with minocycline/EDTA, gentamicin/heparin, or vancomycin/heparin solutions. The catheter-related bacteremia rate was 9.13 per 1,000 catheter days prior to the use of CLS, 1.04 during use of solution, and 7.94 after the CLS were discontinued (p < 0.001).


CONCLUSIONS
These results show a dramatic effect of antimicrobial CLS on the prevention of catheter-related bacteremia.
Feely
Theodore
T
Section on Nephrology, Wake Forest University School of Medicine and Health Systems Management, Winston-Salem, NC 27157, USA.
Copley
Angela
A
Bleyer
Anthony J
AJ
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000382:microbiology; D015314:Dialysis Solutions / Q000627:therapeutic use*; D004338:Drug Combinations; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D015314:Dialysis Solutions; D004338:Drug Combinations