[Catheter lock solution--taurolock for prevention of catheter-related bacteremia in hemodialysis patients].
BACKGROUND
Bacteremia and thrombosis are the major complications of tunneled cuff central vein catheters (TCC) used for haemodialysis. Bacterial biofilm is the source of catheter related bacteremia (CRB). Instillation of catheter lock solution (CLS) containing antibiotic-anticoagulant solution can cure and prevent CRB. The aim of this publication is to report our experience with the use of CLS - TauroLock (Taurolidine and 4% citrate) in the prevention of catheter related bacteremia in hemodialysis patients.


METHODS
Thirteen patients with TCC on chronic hemodialysis were included in the study. Group A: 5 patients with previous inserted catheters and history of at least one bacteremia episode before the study. Group B: 8 patients with new catheters. At the end of each dialysis the catheters were locked with TauroLock until the next dialysis session.


RESULTS
In Group A, the catheter related bacteremia (CRB) was reduced from 9.5-episodes\1000 patients days prior to the study to 1.15 episodes\1000 patients days through 867 days of treatment. In Group B, there were not any CRB during 1179 treatment days in the 8 patients. Due to catheter patency problems, 2500 IU of heparin was added to the TauroLock solution in 3 patients (60%) of group A and in 7 patients (87.5%) of group B and Urokinase instillation in 1 and 3 patients of group A and B respectively.


CONCLUSIONS
The catheter lock solution TauroLock significantly decreased the rate of CRB in HD patients with TCC, to complete prevention in new TCC. Addition of heparin to the TauroLock solution should be considered to maintain catheter patency.
Geron
Ronit
R
Nephrology and Hypertension Department, Western Galilee Hospital, Nahariya, Israel. Ronit.geron@naharia.health.gov.il
Tanchilevski
Olga
O
Kristal
Batya
B
D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D004867:Equipment Design; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors