Preventing Catheter-Related Bacteremia with Taurolidine-Citrate Catheter Locks: A Systematic Review and Meta-Analysis

Liu, Hongbo; Li, Hongmei; Deng, Jing; Chen, Lihua; Lü, Yuan; Wu, Yong

doi:10.1159/000360271

Cited by 49 publications

(46 citation statements)

References 72 publications

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“…In contrast with previous results presented by Liu et al (2014) and Solomon et al (2010), this study detected the presence of similar mechanical complications between the groups, after the exclusion of AVF as a cause for removal. Winnicki et al (2018) reported the results of a randomized multicenter study that evaluated the role of prophylactic therapy using two different treatments: taurolidine-citrate-heparin twice a week and 4% citrate three times a week.…”

Section: Abdulcontrasting

confidence: 99%

“…In recent decades, meta-analyses and systematic reviews have shown the benefits of prophylactic lock therapy compared to heparin for reducing the incidence of CR-BSI in HD patients (Labriola et al, 2008;Jaffer et al, 2008;Yahav et al, 2008;Rabindranath et al, 2009;Snaterse et al, 2011;Zhao et al, 2014;Liu et al, 2013;Liu et al, 2014;Wang et al, 2016;Zang et al, 2017;Zcharioudakis et al, 2014). The ideal solution for locking prophylactic therapy, as well as its longterm adverse effects, is yet to be determined.…”

Section: Introductionmentioning

confidence: 99%

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Cefazolin–gentamicin versus taurolidine–citrate for the prevention of infection in tunneled central catheters in hemodialysis patients: A quasi-experimental trial

Bueloni¹,

Marchi²,

Caetano

et al. 2019

International Journal of Infectious Diseases

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Background: Catheter-related bloodstream infection (CR-BSI) is one of various complications related to hemodialysis (HD). As a result of the high rate of infection, the use of lock solutions for the prevention of CR-BSI has been studied. However, adverse effects of lock solution, such as increased emergence of strains resistant to antibiotics, which is an important concern, need to be investigated further. The aim of this study was to compare the efficacy of lock solution using a combination of cefazolin and gentamicin versus taurolidine and citrate in reducing CR-BSI in patients undergoing HD and to identify any adverse effects. Methods: A prospective observational study was performed at two dialysis centers. Patients using new tunneled central venous catheters (CVC) for HD were included. Patients with a tunneled CVC were assigned to receive either antibiotic lock solution (group 1: gentamicin 7 mg/ml + cefazolin 12 mg/ml + heparin 3500 IU/ml) or lock solution with TauroLock-Hep500 (group 2: taurolidine citrate 4% + heparin 500 IU/ml) during the inter-dialysis period. The patients were allocated to these groups according to the hemodialysis center they were attending. Results: A total of 145 CVCs were implanted in 127 patients and were followed for 15 months: 77 CVCs (65 patients) were placed in group 1 and 68 CVCs (62 patients) in group 2. There was no difference between the two groups with regard to CR-BSI (events per 1000 catheter-days: group 1 = 0.79, group 2 = 1.10; p = 0.18) or exit site infection rates (events per 1000 catheter-days: group 1 = 2.45, group 2 = 1.83; p = 0.37). The groups differed in ESI pathogens, with gram-positive oxacillin-resistant pathogens more frequent in group 1 (31.8% vs. 5.0%; p = 0.003). The two groups were similar in mechanical complications. In the Cox regression analysis, the internal jugular vein site was a protective factor for all catheter removal complications (hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.19-0.91) and mechanical complications (HR 0.16, 95% CI 0.065-0.41); only ESI was a risk factor for all catheter removal complications (HR 1.79, 95% CI 1.04-3.07) and mechanical complications (HR 5.64, 95% CI 1.65-19.3). Conclusions: The efficacy of both lock solutions was similar in preventing infections related to tunneled CVCs for HD. However, there were more oxacillin-resistant strains in patients who received antibiotic lock solution. Further studies are required to determine the optimal drug regimen and concentrations for lock solution and the associated adverse effects.

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Section: Abdulcontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cefazolin–gentamicin versus taurolidine–citrate for the prevention of infection in tunneled central catheters in hemodialysis patients: A quasi-experimental trial

Bueloni¹,

Marchi²,

Caetano

et al. 2019

International Journal of Infectious Diseases

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“…In contrast to prior studies indicating that the use of Taurolock was associated with a higher rate of catheter exchange, our data revealed that catheter exchange was required less frequently during period two than during period one, with 14 exchanges per 100 patient-years during period two and 45 exchanges per 100 patient-years during period one (P = 0.05). Therefore, the greatest benefit of Taurolock may be a reduction in the rate of dialysis catheter exchange [17] [18].…”

Section: Discussionmentioning

confidence: 99%

Taurolock Effectively Reduces Tunneled Dialysis Catheter-Related Infection and Catheter Exchange Rates among Hemodialysis Patients

Malki¹,

Othman²,

Osman³

et al. 2016

OJNeph

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Aims: Catheter-related infection, which is one of the major side effects of the use of dialysis catheters, leads to increases in hospitalization, morbidity and mortality. Antibiotic lock is an option for reducing the incidence of these infections, but there are concerns regarding antibiotic resistance. A prior study demonstrated that Taurolock (a taurolidine lock) may reduce the rate of catheter-related infection. Methods and Material: This investigation was a prospective before-and-after study. During period one, patients continued to use a heparin lock (5000 units/ml) for 6 months. During period two, they were shifted to Taurolock (a solution of 1.35% taurolidine, 4% citrate, and 500 units/ml of heparin) for 6 months. The primary outcome was the incidence of tunneled catheter-related infection and/or catheter exchange, and the secondary outcomes were the effects of Taurolock on catheter flow rate, dialysis adequacy, and catheter malfunction rate. Results: A total of 49 patients were included in this study. During period one, the primary outcome occurred 17 times, with an incidence rate of 86.8 per 100 patient-years; during period two, the primary outcome occurred 7 times, with an incidence rate of 32.6 per 100 patient-years (incidence rate ratio: 2.65, 95% confidence interval (CI): 1.05-7.6, P = 0.023). There was no significant difference between the two periods with respect to mean catheter blood flow rate (P = 0.29). During period one, thrombolytic therapy (TPA) lock was indicated on 19 occasions, with an incidence rate of 97 per 100 patient-years; during period two, TPA lock was indicated on 53 occasions, with an incidence rate of 247.5 per 100 patient-years (incidence rate ratio: 0.3, 95% CI: 0.21-0.67, P = 0.0003). Conclusions: We demonstrated that Taurolock usage is safe and effective for the prevention of dialysis catheter-related infection and/or catheter exchange.

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“…Taurolidine is an effective antibacterial substance [1][2][3][4][5][6][7][8] utilized to counteract catheterrelated infections [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. The substance is further effective against malignancy both, in vivo and in vitro [25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Taurolidine Sensitivity of Eryptosis, the Suicidal Erythrocyte Death

Fink

Bhuyan

Zacharopoulou

et al. 2018

Cell Physiol Biochem

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Background/Aims: The taurine derivative Taurolidine is effective against diverse bacteria and tumor growth. In the treatment of cancer, the substance is effective in part by triggering suicidal death or apoptosis of tumor cells. The Taurolidine-induced apoptosis involves mitochondria. Erythrocytes lack mitochondria but are nevertheless able to enter suicidal erythrocyte death or eryptosis, which is characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine translocation to the erythrocyte surface. Signaling of eryptosis includes increase of cytosolic Ca²⁺ activity ([Ca²⁺]_i), oxidative stress and ceramide. The present study explores, whether Taurolidine induces eryptosis and, if so, which cellular mechanisms are involved. Methods: Phosphatidylserine exposure at the cell surface was estimated using annexin-V-binding, cell volume using forward scatter, [Ca²⁺]_i using Fluo3-fuorescence, reactive oxygen species (ROS) formation using 2’,7’-dichlorodihydrofuorescein (DCF)-dependent fluorescence, and ceramide abundance using specific antibodies. Results: A 48 hours exposure of human erythrocytes to Taurolidine (60 µg/ml) significantly enhanced the percentage of annexin-V-binding cells, significantly decreased forward scatter and significantly increased Fluo3-fluorescence and ceramide abundance, but not DCF-fluorescence. The effect of Taurolidine on annexin-V-binding was virtually abrogated by removal of extracellular Ca²⁺. Conclusion: Taurolidine triggers cell shrinkage and phospholipid scrambling of the erythrocyte cell membrane, an effect at least in part due to Ca²⁺ entry and paralleled by increase of ceramide abundance.

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Preventing Catheter-Related Bacteremia with Taurolidine-Citrate Catheter Locks: A Systematic Review and Meta-Analysis

Cited by 49 publications

References 72 publications

Cefazolin–gentamicin versus taurolidine–citrate for the prevention of infection in tunneled central catheters in hemodialysis patients: A quasi-experimental trial

Cefazolin–gentamicin versus taurolidine–citrate for the prevention of infection in tunneled central catheters in hemodialysis patients: A quasi-experimental trial

Taurolock Effectively Reduces Tunneled Dialysis Catheter-Related Infection and Catheter Exchange Rates among Hemodialysis Patients

Taurolidine Sensitivity of Eryptosis, the Suicidal Erythrocyte Death

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