title: Significant reduction in central venous catheter-related bloodstream infections in children on HPN after starting treatment with taurolidine line lock.
abstract: OBJECTIVE
  The aim of this study was to review the incidence and type of central venous catheter-related bloodstream infection in children on treatment with home parenteral nutrition (PN) before and after the introduction of taurolidine. Taurolidine is a catheter lock solution that prevents biofilm formation and has broad-spectrum bactericidal and antifungal action. Its use in pediatric patients on PN has only been reported in case studies.
  
  
  METHODS
  A total of 19 children were reviewed, with the diagnoses of enteropathy (8 cases), short bowel syndrome (7 cases), and gastrointestinal dysmotility (4 cases). Incidence and type of sepsis were reviewed for 8 to 12 months pre- (when heparin was used) and 2 to 33 months postintroduction of the taurolidine catheter lock.
  
  
  RESULTS
  There were 8.6 episodes of catheter-related bloodstream infections per 1000 catheter days with heparin and 1.1 episodes per 1000 catheter days with taurolidine (P=0.002). A total of 14 of the 19 patients (74%) had no infections for up to 33 months after changing to taurolidine. No reports of multiresistant organisms or adverse effects with taurolidine were found.
  
  
  CONCLUSIONS
  Taurolidine line lock was associated with a decreased incidence of catheter-related bloodstream infections. This finding supports its use in patients with a history of septicemia on treatment with cyclical PN.
authors.affiliation: Gastroenterology Department, Great Ormond Street Hospital, London, UK.
authors.forename: Hui-Ping
authors.initials: HP
authors.lastname: Chu
authors.forename: Joanne
authors.initials: J
authors.lastname: Brind
authors.forename: Rajeev
authors.initials: R
authors.lastname: Tomar
authors.forename: Susan
authors.initials: S
authors.lastname: Hill
mesh_terms: D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000097:blood / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005767:Gastrointestinal Diseases / Q000628:therapy; D005769:Gastrointestinal Motility; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016331:Parenteral Nutrition, Home / Q000009:adverse effects*; D018805:Sepsis / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D012778:Short Bowel Syndrome / Q000628:therapy; D013654:Taurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013829:Thiadiazines / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D000925:Anticoagulants; D013829:Thiadiazines; D013654:Taurine; C012566:taurolidine; D006493:Heparin