title: Taurolidine lock solution in the secondary prevention of central venous catheter-associated bloodstream infection in home parenteral nutrition patients.
abstract: OBJECTIVE
  Central venous catheter-associated bloodstream infection (CBSI) is a serious complication in patients on home parenteral nutrition (HPN). The aim was to analyze the impact of taurolidine-citrate lock solution (TLS) on CBSI rate in HPN patients with a high risk of catheter infection.
  
  
  METHODS
  This retrospective study compared CBSI rates 12 months before and 12 months after implementation of TLS. In the first period, only standardized strategies were used to reduce the CBSI rate. In the second period, TLS was injected into the catheter at the end of parenteral nutrition. The CBSI rate with a confident interval was calculated as Poisson event rates, and compared by testing for homogeneity of rates.
  
  
  RESULTS
  15 patients were included. During the 24 months, the CBSI rate was 6.58/1000 catheter-days in the first period and 1.09/1000 catheter-days in the second period (p < 0.001). In patients with TLS once a week (n = 8), the CBSI rate decreased from 4.8/1000 catheter-days to 1.37/1000 catheter-days (p = 0.02) and in patients with TLS after each TPN (n = 7), the CBSI rate decreased from 8.61/1000 catheter-days to 0.78/1000 catheter-days (p = 0.001).
  
  
  CONCLUSIONS
  In HPN patients, TLS associated with standardized precautions significantly reduced the CBSI rate.
authors.affiliation: Inserm Unit 1060/Inra 1235, University of Lyon, Lyon, France. abdoulayek2002@yahoo.fr
authors.forename: Abdoulaye
authors.initials: A
authors.lastname: Touré
authors.forename: Madeleine
authors.initials: M
authors.lastname: Lauverjat
authors.forename: Catherine
authors.initials: C
authors.lastname: Peraldi
authors.forename: Michèle
authors.initials: M
authors.lastname: Boncompain-Gerard
authors.forename: Patrick
authors.initials: P
authors.lastname: Gelas
authors.forename: Didier
authors.initials: D
authors.lastname: Barnoud
authors.forename: Cécile
authors.initials: C
authors.lastname: Chambrier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000494:pharmacology*; D055499:Catheter-Related Infections / Q000517:prevention & control*; D062905:Central Venous Catheters / Q000382:microbiology*; D016972:Enterobacter cloacae / Q000187:drug effects / Q000472:pathogenicity; D004926:Escherichia coli / Q000187:drug effects / Q000472:pathogenicity; D005260:Female; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000472:pathogenicity; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods*; D012996:Solutions; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000472:pathogenicity; D041181:Staphylococcus hominis / Q000187:drug effects / Q000472:pathogenicity; D013654:Taurine / Q000031:analogs & derivatives* / Q000494:pharmacology; D013829:Thiadiazines / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D012996:Solutions; D013829:Thiadiazines; D013654:Taurine; C012566:taurolidine