title: Antimicrobial lock therapy in central-line associated bloodstream infections: a systematic review.
abstract: OBJECTIVE
  Antimicrobial lock therapy (ALT) seems a promising approach for treatment of central line associated bloodstream infections (CLABSI). The recent introduction of molecules such as daptomycin and tigecycline, alone or in combination with other molecules, improved chances of efficacy of ALT, due to their activity on the bacterial biofilm. Our aim was to review the literature concerning ALT for CLABSI, including data concerning novel molecules.
  
  
  METHODS
  We included case-control studies evaluating two or more molecules as ALT in central venous catheter infections extracted from the Medline database. Among 221 available articles in Pubmed, 54 were selected for their particular interest concerning ALT.
  
  
  RESULTS
  Incidence of CLABSI is high worldwide. Mechanisms of catheter infection include contamination by skin bacteria, hand contamination and hematogenous diffusion. Catheter-infection is associated with biofilm formation, which reduces the efficacy of ALT. The most promising situation for ALT to succeed in salvaging a catheter appears to be coagulase-negative Staphylococcus infection, which is the main causative agent of CLABSI. Daptomycin, Tigecycline, Ethanol and Taurolidine appear as the best options for treating CLABSI; data are mostly available for Daptomycin, which showed, alone or associated with Rifampin, good in vitro potency on biofilm, but few in vivo data exist on efficacy.
  
  
  CONCLUSIONS
  The introduction of novel molecules has increased chances of catheter salvage with ALT in case of CLABSI, but further in vivo studies are needed.
authors: Department of Internal Medicine, Infectious Diseases, Cannes General Hospital, Cannes, France, m.vassallo@ch-cannes.fr.
authors: Matteo
authors: M
authors: Vassallo
authors: Brigitte
authors: B
authors: Dunais
authors: Pierre-Marie
authors: PM
authors: Roger
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D055499:Catheter-Related Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D002405:Catheterization, Central Venous; D006801:Humans
chemical_list: D000890:Anti-Infective Agents
references: Clin Infect Dis. 2011 Nov;53(9):e129-32
references: 21890750
references: J Clin Oncol. 2013 Apr 1;31(10):1357-70
references: 23460705
references: J Antimicrob Chemother. 2006 Jun;57(6):1110-5
references: 16556639
references: Pediatr Blood Cancer. 2013 Aug;60(8):1292-8
references: 23417891
references: Antimicrob Agents Chemother. 2013 Jan;57(1):1-8
references: 23070153
references: Antimicrob Agents Chemother. 2012 Feb;56(2):613-7
references: 22123684
references: Infection. 2015 Feb;43(1):107-9
references: 25112453
references: Eur J Clin Microbiol Infect Dis. 2013 Feb;32(2):199-206
references: 23079900
references: Clin Infect Dis. 2001 Oct 15;33(8):1387-92
references: 11565080
references: Antimicrob Agents Chemother. 2012 Dec;56(12):6310-8
references: 23027191
references: J Antimicrob Chemother. 2010 Mar;65(3):525-30
references: 20083550
references: J Infect. 2014 Jun;68(6):548-52
references: 24412247
references: Eur J Vasc Endovasc Surg. 2010 Dec;40(6):817-22
references: 20869272
references: Am J Nephrol. 2011;34(5):415-22
references: 21934302
references: Am J Kidney Dis. 2014 Mar;63(3):479-90
references: 24125729
references: Pharmacotherapy. 2005 Feb;25(2):211-27
references: 15767236
references: Nephrol Dial Transplant. 2007 Aug;22(8):2239-46
references: 17403700
references: APMIS. 2012 Aug;120(8):605-11
references: 22779682
references: Enferm Infecc Microbiol Clin. 2013 Dec;31(10):655-9
references: 23642281
references: Infect Control Hosp Epidemiol. 2013 Sep;34(9):893-9
references: 23917902
references: Am J Surg. 2014 Jun;207(6):817-23
references: 24576582
references: Antimicrob Agents Chemother. 2002 Jun;46(6):1674-9
references: 12019075
references: Clin Infect Dis. 2009 Jul 1;49(1):1-45
references: 19489710
references: Diagn Microbiol Infect Dis. 2009 Feb;63(2):208-12
references: 19026506
references: Clin Nutr. 2012 Oct;31(5):602-8
references: 22424704
references: Clin Nutr. 2009 Aug;28(4):365-77
references: 19464090
references: Antimicrob Agents Chemother. 2007 May;51(5):1656-60
references: 17353249
references: Antimicrob Agents Chemother. 2013 Aug;57(8):3555-60
references: 23669393
references: Clin Nutr. 1990 Aug;9(4):220-5
references: 16837359
references: J Med Microbiol. 2012 Sep;61(Pt 9):1248-53
references: 22580911
references: PLoS One. 2014 Mar 27;9(3):e91838
references: 24675993
references: J Pediatr Hematol Oncol. 2003 Aug;25(8):616-21
references: 12902914
references: Saudi J Kidney Dis Transpl. 2010 Jan;21(1):54-8
references: 20061693
references: Infection. 2015 Feb;43(1):29-36
references: 25331552
references: Antimicrob Agents Chemother. 2011 Sep;55(9):4081-9
references: 21709082
references: Clin Infect Dis. 2011 May;52(9):e162-93
references: 21460264
references: Int J Antimicrob Agents. 2008 Dec;32(6):515-8
references: 18783924
references: J Leukoc Biol. 1995 Sep;58(3):299-306
references: 7665985
references: Pediatr Blood Cancer. 2014 Oct;61(10):1811-5
references: 24923808
references: Int J Antimicrob Agents. 2012 Apr;39(4):338-42
references: 22364717
references: Clin Pharmacol. 2010;2:123-30
references: 22291495
references: Antimicrob Agents Chemother. 2013 Apr;57(4):1998-2000
references: 23403427
references: J Antimicrob Chemother. 2014 Oct;69(10):2611-9
references: 24891431
references: J Am Soc Nephrol. 2002 Aug;13(8):2133-9
references: 12138146
references: Int J Clin Pract. 2012 Mar;66(3):305-8
references: 22340450
references: Infection. 2014 Feb;42(1):5-13
references: 23975584
references: Am J Health Syst Pharm. 2012 Aug 15;69(16):1405-9
references: 22855107
references: Antimicrob Agents Chemother. 2013 May;57(5):2369-71
references: 23422915
references: J Am Soc Nephrol. 2014 Dec;25(12):2927-41
references: 24854263
references: Saudi J Kidney Dis Transpl. 2012 Jul;23(4):743-54
references: 22805387
references: Emerg Infect Dis. 2001 Mar-Apr;7(2):277-81
references: 11294723
references: J Pediatr Gastroenterol Nutr. 2014 Jun;58(6):703-8
references: 24590214
references: Semin Dial. 2013 Mar-Apr;26(2):223-6
references: 22856885