Document Detail


Prevention of dialysis catheter-related sepsis with a citrate-taurolidine-containing lock solution.
MedLine Citation:
PMID:  14993498     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The use of haemodialysis catheters is complicated by catheter-related sepsis. Intraluminal colonization of the catheter with bacteria is important in the pathogenesis of catheter-related sepsis. The use of a catheter lock solution containing the antimicrobial taurolidine might prevent bacterial colonization, thereby reducing the incidence of catheter-related sepsis. METHODS: In a randomized prospective trial, patients receiving a dialysis catheter were included and catheters were locked with either heparin or a citrate-taurolidine-containing solution. Blood cultures drawn from the catheter lumen were routinely taken every 2 weeks and at time of removal of the catheter to detect bacterial colonization. Catheter-related sepsis and exit-site infections were registered for both groups. RESULTS: A total of 76 catheters were inserted in 58 patients. The incidence of catheter colonization progressed slowly over time with no differences between dialysis catheters filled with heparin or citrate-taurolidine-containing solution. The number of exit-site infections was also similar between both groups. In the heparin group, four cases of catheter-related sepsis occurred as opposed to no sepsis episodes in the patients with catheters locked with the citrate-taurolidine-containing solution (P<0.5). No side effects with the use of citrate-taurolidine catheter lock solution were noted. CONCLUSIONS: This study shows that catheter filling with a solution containing the antimicrobial taurolidine may significantly reduce the incidence of catheter-related sepsis. Taurolidine appears to be effective and safe and does not carry the risk for side effects that have been reported for other antimicrobial lock solutions containing gentamicin or high concentrations of citrate.
Authors:
Michiel G H Betjes; Madelon van Agteren
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2004-02-19
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  19     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-05-19     Completed Date:  2004-09-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1546-51     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Division of Nephrology, Erasmus Medical Center, Dijkzigt Rotterdam, Dr Molewater plein 40, 3015 GD Rotterdam, The Netherlands. m.g.h.betjes@erasmusmc.nl
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MeSH Terms
Descriptor/Qualifier:
Anti-Infective Agents / administration & dosage*
Bacterial Infections / etiology,  prevention & control*
Catheterization, Central Venous / adverse effects*
Catheters, Indwelling
Citric Acid / administration & dosage*
Equipment Contamination / prevention & control*
Female
Humans
Male
Middle Aged
Prospective Studies
Renal Dialysis / instrumentation*
Sepsis / etiology,  prevention & control*
Solutions
Taurine / administration & dosage*,  analogs & derivatives*
Thiadiazines / administration & dosage*
Chemical
Reg. No./Substance:
0/Anti-Infective Agents; 0/Solutions; 0/Thiadiazines; 107-35-7/Taurine; 19388-87-5/taurolidine; 77-92-9/Citric Acid

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