NDT Advance Access originally published online on February 19, 2004
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Nephrol Dial Transplant (2004) 19: 1546-1551
Nephrol Dial Transplant Vol. 19 No. 6 © ERA-EDTA 2004; all rights reserved
Original Article
Prevention of dialysis catheter-related sepsis with a citrate–taurolidine-containing lock solution
Department of Internal Medicine, Division of Nephrology, Erasmus Medical Center, Dijkzigt Rotterdam, The Netherlands
Correspondence and offprint requests to: Michiel G. H. Betjes, MD, PhD, Erasmus Medical Center, Dijkzigt Rotterdam, Department of Internal Medicine, Division of Nephrology, Dr Molewater plein 40, 3015 GD Rotterdam, The Netherlands. Email: m.g.h.betjes{at}erasmusmc.nl
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.
Keywords: catheter; haemodialysis; lock; sepsis; taurolidine
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Balestrino, B. Souweine, N. Charbonnel, A. Lautrette, C. Aumeran, O. Traore, and C. Forestier Eradication of microorganisms embedded in biofilm by an ethanol-based catheter lock solution Nephrol. Dial. Transplant., October 1, 2009; 24(10): 3204 - 3209. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Vandecasteele, J. R. Boelaert, and A. S. De Vriese Staphylococcus aureus Infections in Hemodialysis: What a Nephrologist Should Know Clin. J. Am. Soc. Nephrol., August 1, 2009; 4(8): 1388 - 1400. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. S. Rabindranath, T. Bansal, J. Adams, R. Das, R. Shail, A. M. MacLeod, C. Moore, and A. Besarab Systematic review of antimicrobials for the prevention of haemodialysis catheter-related infections Nephrol. Dial. Transplant., July 10, 2009; (2009) gfp327v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Steczko, S. R. Ash, D. E. Nivens, L. Brewer, and R. K. Winger Microbial inactivation properties of a new antimicrobial/antithrombotic catheter lock solution (citrate/methylene blue/parabens) Nephrol. Dial. Transplant., June 1, 2009; 24(6): 1937 - 1945. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Sauer, J. Steczko, and S. R. Ash Effect of a solution containing citrate/Methylene Blue/parabens on Staphylococcus aureus bacteria and biofilm, and comparison with various heparin solutions J. Antimicrob. Chemother., May 1, 2009; 63(5): 937 - 945. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Winnett, J. Nolan, M. Miller, and N. Ashman Trisodium citrate 46.7% selectively and safely reduces staphylococcal catheter-related bacteraemia Nephrol. Dial. Transplant., November 1, 2008; 23(11): 3592 - 3598. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Onder, J. Chandar, N. Simon, R. Diaz, O. Nwobi, C. L. Abitbol, and G. Zilleruelo Comparison of tissue plasminogen activator-antibiotic locks with heparin-antibiotic locks in children with catheter-related bacteraemia Nephrol. Dial. Transplant., August 1, 2008; 23(8): 2604 - 2610. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Labriola, R. Crott, and M. Jadoul Preventing haemodialysis catheter-related bacteraemia with an antimicrobial lock solution: a meta-analysis of prospective randomized trials Nephrol. Dial. Transplant., May 1, 2008; 23(5): 1666 - 1672. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. T. James, J. Conley, M. Tonelli, B. J. Manns, J. MacRae, B. R. Hemmelgarn, and for the Alberta Kidney Disease Network Meta-analysis: Antibiotics for Prophylaxis against Hemodialysis Catheter-Related Infections Ann Intern Med, April 15, 2008; 148(8): 596 - 605. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Y. Lee, K. S. Ko, J.-H. Song, and K. R. Peck In vitro effectiveness of the antibiotic lock technique (ALT) for the treatment of catheter-related infections by Pseudomonas aeruginosa and Klebsiella pneumoniae J. Antimicrob. Chemother., October 1, 2007; 60(4): 782 - 787. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Bleyer Use of Antimicrobial Catheter Lock Solutions to Prevent Catheter-Related Bacteremia Clin. J. Am. Soc. Nephrol., September 1, 2007; 2(5): 1073 - 1078. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P.C. Thomson, C.M. Stirling, C.C. Geddes, S.T. Morris, and R.A. Mactier Vascular access in haemodialysis patients: a modifiable risk factor for bacteraemia and death QJM, July 1, 2007; 100(7): 415 - 422. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Allon Current Management of Vascular Access Clin. J. Am. Soc. Nephrol., July 1, 2007; 2(4): 786 - 800. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Grudzinski, P. Quinan, S. Kwok, and A. Pierratos Sodium citrate 4% locking solution for central venous dialysis catheters--an effective, more cost-efficient alternative to heparin Nephrol. Dial. Transplant., February 1, 2007; 22(2): 471 - 476. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Sherertz, M. S. Boger, C. A. Collins, L. Mason, and I. I. Raad Comparative in vitro efficacies of various catheter lock solutions. Antimicrob. Agents Chemother., May 1, 2006; 50(5): 1865 - 1868. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. Weijmer, M. A. van den Dorpel, P. J.G. Van de Ven, P. M. ter Wee, J. A.C.A. van Geelen, J. O. Groeneveld, B. C. van Jaarsveld, M. G. Koopmans, C. Y. le Poole, A. M. Schrander-Van der Meer, et al. Randomized, Clinical Trial Comparison of Trisodium Citrate 30% and Heparin as Catheter-Locking Solution in Hemodialysis Patients J. Am. Soc. Nephrol., September 1, 2005; 16(9): 2769 - 2777. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Cappelli, C. Tetta, and B. Canaud Is biofilm a cause of silent chronic inflammation in haemodialysis patients? A fascinating working hypothesis Nephrol. Dial. Transplant., February 1, 2005; 20(2): 266 - 270. [Full Text] [PDF]
|
|