title: Short-course daptomycin lock and systemic therapy for catheter-related bloodstream infections: a retrospective cohort study in cancer patients with surgically implanted devices.
abstract: OBJECTIVE
  Few in vivo studies have been reported describing efficacy and duration of antibiotic lock therapy (ALT) with daptomycin (DPT) for long-term catheter-related bloodstream infections (CRBSI) due to coagulase-negative staphylococci (CoNS). We retrospectively analysed the efficacy of short-course ALT with DPT in combination with systemic treatment (ST) for CoNS-associated CRBSI in our hospital.
  
  
  METHODS
  Patients admitted for CoNS-associated CRBSI and treated with DPT as ALT and ST were retrospectively analysed. Success was defined as preservation of the catheter device 30 days after ending treatment. Catheter removal within 30 days of discontinuing treatment, for either microbiological documentation of CRBSI relapse or re-occurrence of unexplained fever, was considered as failure.
  
  
  RESULTS
  Among 7610 patients admitted to the Departments of Internal Medicine/Infectious Diseases and Pneumology in Cannes from January 2013 to November 2015, we identified 28 episodes of CoNS-associated CRBSI. Seven patients died of cancer during follow-up. Thus, 21 episodes were analysed among 20 patients (median age 67 years, 12 males, all treated for neoplasia and carrying a port-a-cath® device). Staphylococcus epidermidis was the main agent responsible for CRBSI. Median duration of systemic and ALT DPT was 3 days, in combination with rifampin for 4 days and then generally followed by a switch to oral drugs, most frequently cotrimoxazole or linezolid, to achieve 14 median days of treatment. Clinical success and failure rates were 76% and 24%, respectively.
  
  
  CONCLUSIONS
  Short-course DPT as ALT, combined with 14 days of ST, allowed conservative management of CoNS-associated CRBSI in surgically implanted-catheters in three-fourth of cases.
authors.affiliation: a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
authors.forename: Matteo
authors.initials: M
authors.lastname: Vassallo
authors.affiliation: b Department of Medical Informatics , Cannes General Hospital , France.
authors.forename: Pierre-Luc
authors.initials: PL
authors.lastname: Genillier
authors.affiliation: c Department of Public Health , Nice University Hospital , France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Dunais
authors.affiliation: a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
authors.forename: Regis
authors.initials: R
authors.lastname: Kaphan
authors.affiliation: a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Saudes
authors.affiliation: d Department of Pneumology , Cannes General Hospital , France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Duval
authors.affiliation: d Department of Pneumology , Cannes General Hospital , France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Rolland
authors.affiliation: d Department of Pneumology , Cannes General Hospital , France.
authors.forename: Valerie
authors.initials: V
authors.lastname: Jullien
authors.affiliation: a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Weiss
authors.affiliation: a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
authors.forename: Elea
authors.initials: E
authors.lastname: Blanchouin
authors.affiliation: a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
authors.forename: Annick
authors.initials: A
authors.lastname: Boscagli
authors.affiliation: d Department of Pneumology , Cannes General Hospital , France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Perrin
authors.affiliation: a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Montagne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy* / Q000209:etiology; D055499:Catheter-Related Infections / Q000188:drug therapy* / Q000209:etiology; D002408:Catheters, Indwelling / Q000009:adverse effects*; D017576:Daptomycin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000382:microbiology; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin
keywords: Antibiotic lock therapy; Catheter-related bloodstream infections; Daptomycin