Prevention of Tunneled Haemodialysis Catheter (Tc) Related Infections Using Catheter Restricted Filling With Gentamicin and Citrate

Dogra, Gursharan; Herson, Helen; Irish, Ashley; Hutchison, Brian; Moody, H.

doi:10.1046/j.1440-1797.2002.00007-1-54.x

Cited by 12 publications

(8 citation statements)

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“…Studies on adults with CRB report a mortality of up to 10% [32]. Multiple prospective trials have shown that the use of prophylactic ABLs can significantly decrease the incidence of CRBs and the associated mortality in haemodialysis patients [35][36][37]. However, recent K/DOQI guidelines for vascular access do not make recommendations for the preventive use of ABLs [1].…”

Section: Discussionmentioning

confidence: 99%

Comparison of tissue plasminogen activator-antibiotic locks with heparin-antibiotic locks in children with catheter-related bacteraemia

Onder

Chandar

Simon³

et al. 2008

Nephrology Dialysis Transplantation

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Background. An accepted pathogenesis of catheter-related bacteraemia (CRB) is the seeding of microorganisms from the intraluminal biofilm of central venous catheters. Antibiotic locks (ABL) are solutions containing high concentrations of antimicrobials with or without anticoagulants that aim to destroy the biofilm. Methods. In this study, two different ABL solutions, tissue plasminogen activator (TPA)-based and heparin-based ABL, used in conjunction with systemic antibiotics, were prospectively compared in the treatment of CRB. Results. A total of 42 children on chronic haemodialysis with 11 016 catheter-days were observed for signs and symptoms of CRB over a period of 10 months. Twentyfour CRBs were diagnosed in 18 children (2.2 CRB/1000 catheter-days) and were treated with the protocol. Symptoms of CRB resolved in 83% within 48 h of treatment. None of the infected catheters required early emergent exchange or removal for poorly controlled CRB. Six children had recurrence of CRB within 6 weeks, of which four required catheter exchange. There was no specific microorganism or type of CRB that predisposed to higher recurrence rates. The mean infection-free survival of the catheters following TPA-ABL treatment was shorter than that following heparin-ABL treatment, but was not statistically significant by the log-rank test (126.8 ± 81.6 days versus 154.5 ± 70.4 days). Conclusion. Both TPA-ABL and heparin-ABL used in conjunction with systemic antibiotics can effectively clear CRB without significant late recurrence at 6 weeks. Early use of ABL for management of CRB can potentially decrease the need for catheter removal, thus salvaging vascular access sites.

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Section: Discussionmentioning

confidence: 99%

Comparison of tissue plasminogen activator-antibiotic locks with heparin-antibiotic locks in children with catheter-related bacteraemia

Onder

Chandar

Simon³

et al. 2008

Nephrology Dialysis Transplantation

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“…There have been several reports of leakage of catheter‐locking agents from dual lumen hemodialysis catheters into the systemic circulation 1–7 . Karaaslan et al 1 demonstrated elevated APTT ratios 10 minutes after injection of 2 mL of heparin (10,000 U per catheter) into TCCs.…”

Section: Discussionmentioning

confidence: 99%

“…Leakage of hemodialysis catheter‐locking solutions into the circulation has been reported in in vitro and in vivo studies, 1–6 although there have been few reports of serious clinical adverse events. We describe a case of heparin leak from a hemodialysis catheter, which caused significant clinical bleeding requiring multiple transfusions and may have ultimately been responsible for the patient's death after transplantation.…”

Section: Introductionmentioning

confidence: 99%

Heparin leak from a hemodialysis catheter causing major bleeding, ultimately leading to transplant rejection and death

Dreyer

Lawton

Jose

2008

Hemodialysis International

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Leakage of hemodialysis catheter-locking solutions into the circulation has been reported in in vitro and in vivo studies, although there have been few reports of serious clinical adverse events. We describe a case of heparin leak from a hemodialysis catheter, which caused significant clinical bleeding requiring multiple transfusions and may have ultimately been responsible for the patient's death after transplantation.

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“…Consequently, the long-term risk:benefit of antimicrobial locks is uncertain. Significant side effects of antimicrobial locks that have been documented in the above trials included hypocalcaemia (Power et al, 2009) digital parasthesiae (Power et al, 2009) and ototoxicity in 10% of those using gentamicin based catheter locks (Dogra et al, 2002). Moreover, there are significant concerns that long term use of antimicrobial locks may promote multiresistant organisms (MROs).…”

Section: Antimicrobial Locksmentioning

confidence: 99%

Hemodialysis Access Infections, Epidemiology, Pathogenesis and Prevention

Gunatillake¹,

Jarvis²,

Johnson³

2011

Technical Problems in Patients on Hemodialysis

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Prevention of Tunneled Haemodialysis Catheter (Tc) Related Infections Using Catheter Restricted Filling With Gentamicin and Citrate

Cited by 12 publications

References 0 publications

Comparison of tissue plasminogen activator-antibiotic locks with heparin-antibiotic locks in children with catheter-related bacteraemia

Comparison of tissue plasminogen activator-antibiotic locks with heparin-antibiotic locks in children with catheter-related bacteraemia

Heparin leak from a hemodialysis catheter causing major bleeding, ultimately leading to transplant rejection and death

Hemodialysis Access Infections, Epidemiology, Pathogenesis and Prevention

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