Taurolidine lock is highly effective in preventing catheter-related bloodstream infections in patients on home parenteral nutrition: A heparin-controlled prospective trial

Bisseling, Tanya M.; Willems, M.C.; Versleijen, Michelle; Hendriks, Jan C.M.; Vissers, R.; Wanten, Geert

doi:10.1016/j.clnu.2009.12.005

Cited by 108 publications

(96 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Taurolidine lock solutions have been evaluated in clinical trials for prevention of CLABSI, with mixed clinical results. Some trials reported significant decreases in CLABSI versus results with heparin locks (29), and others did not (23). In a multicenter, doubleblind, randomized, controlled clinical trial in hemodialysis patients, Solomon et al (23) reported that 1.35% taurolidine-3.5% citrate (TC) lock solution did not significantly decrease bacteremia compared to the level in catheters locked with heparin (23).…”

Section: Figmentioning

confidence: 99%

In Vitro Assessment of the Antimicrobial Efficacy of Optimized Nitroglycerin-Citrate-Ethanol as a Nonantibiotic, Antimicrobial Catheter Lock Solution for Prevention of Central Line-Associated Bloodstream Infections

Reitzel

Rosenblatt

Hirsh-Ginsberg

et al. 2016

Antimicrob Agents Chemother

View full text Add to dashboard Cite

cThe rapid, broad-spectrum, biofilm-eradicating activity of the combination of 0.01% nitroglycerin, 7% citrate, and 20% ethanol and its potential as a nonantibiotic, antimicrobial catheter lock solution (ACLS) were previously reported. Here, a nitroglycerincitrate-ethanol (NiCE) ACLS optimized for clinical assessment was developed by reducing the nitroglycerin and citrate concentrations and increasing the ethanol concentration. Biofilm-eradicating activity was sustained when the ethanol concentration was increased from 20 to 22% which fully compensated for reducing the citrate concentration from 7% to 4% as well as the nitroglycerin concentration from 0.01% to 0.0015% or 0. C entral line-associated bloodstream infections (CLABSIs) pose a significant public health problem in the United States. More than 7 million patients require central venous access each year, resulting in an estimated 250,000 CLABSIs, approximately 30,000 attributable deaths (1), and substantial treatment costs of at least $45,000 per infection (2). The majority of CLABSIs occur in chronically catheterized patients, such as cancer, hemodialysis, or critical care patients. Long-term catheters, such as central venous catheters (CVCs), peripherally inserted central catheters (PICCs), ports, and dialysis catheters, are susceptible to internal colonization of the catheter lumens due to repeated catheter manipulation and infusions. Biofilm formation on the catheter surfaces can serve as the primary source of CLABSI and can be highly resistant to eradication by systemic antibiotic therapy. Several bundled measures have been proposed for both treatment and prevention of CLABSIs, most of which center around reducing and preventing colonization at the skin insertion site or at connections (3). While bundles have been shown to decrease the risk of CLABSI in short-term CVCs (Ͻ30 days of dwell time), approximately 90% of CLABSIs in longer-term catheters are luminally sourced (4, 5). While antimicrobial coatings exist that do cover luminal surfaces, the duration of protection is limited to only a few weeks (6). Because disinfecting antimicrobial catheter lock solutions (ACLSs) can be repetitively instilled, they have emerged as another approach to prevent luminally sourced CLABSIs.Antimicrobial lock therapy solutions for preventing CLABSI have been reported to include prophylactic applications of antibiotics, antifungals, or antiseptics such as ethanol (EtOH) (7,8). The development of microbial resistance is of great concern with prophylactic antibiotic ACLSs (9). Alternatively, high-concentration antiseptic ethanol ACLSs have been studied. An ACLS consisting of 70% ethanol was not effective in decreasing intraluminal CLABSI and was associated with adverse events such as dizziness (10). Ethanol ACLSs with concentrations of greater than 30% have also been associated with clotting, transient dizziness, and compromising catheter integrity in polyurethane catheters (11). Use of ethanol locks with ethanol concentrations greater than 28% has been further advised ...

show abstract

Section: Figmentioning

confidence: 99%

In Vitro Assessment of the Antimicrobial Efficacy of Optimized Nitroglycerin-Citrate-Ethanol as a Nonantibiotic, Antimicrobial Catheter Lock Solution for Prevention of Central Line-Associated Bloodstream Infections

Reitzel

Rosenblatt

Hirsh-Ginsberg

et al. 2016

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…0.0001). 59 The use of antimicrobial locks should not, however, be considered a substitute for meticulous catheter care. Patients with CVC infections usually present with symptoms and signs such as pyrexia and tachycardia during infusion.…”

Section: Complications Of Long-term Pnmentioning

confidence: 99%

Review article: the management of long‐term parenteral nutrition

Dibb

Teubner

Theis

et al. 2013

Aliment Pharmacol Ther

137

108

View full text Add to dashboard Cite

SummaryBackgroundHome parenteral nutrition (HPN) is currently the management of choice for patients with chronic intestinal failure.AimTo summarise the major issues in delivering long‐term parenteral nutrition (>3 months) and assess outcome as per complications, mortality and quality of life. To assess the evidence for the therapeutic use of trophic factors such as teduglutide and to review evolving therapeutic options in the treatment of chronic intestinal failure.MethodsA literature search using PubMed and MEDLINE databases was performed.ResultsSafe delivery of HPN relies upon individualised formulations of parenteral nutrition administered via carefully maintained central venous catheters by trained patients or carers, supported by a skilled multidisciplinary team. Early diagnosis and treatment of complications including catheter‐associated blood stream infection (reported incidence 0.14–0.83 episodes/patient‐year on HPN) and central venous thrombosis (reported incidence 0.03 episodes/patient‐year) is important to minimise mortality and morbidity. There is a significant variation in the reported incidence of both hepatobiliary complications (19–75%) and advanced liver disease (0–50%). Five‐year survival rates in large centres are reported between 60% and 78% with survival primarily related to underlying diagnosis. Long‐term survival remains higher on HPN than with intestinal transplantation. The role of intestinal lengthening procedures is yet to be validated in adults.ConclusionsHome parenteral nutrition delivered by skilled nutrition teams has low incidences of catheter‐related complications. Most deaths relate to the underlying disease. Therapies such as teduglutide and small bowel transplantation appear promising, but home parenteral nutrition appears likely to remain the bedrock of management in the near term.

show abstract

“…It can be used in infections with resistance against a wide range of antibiotics, such as staphylococcus resistant to metisiline and enterococcus resistant to vancomycine. [19,23] In our study, taurolidine has been explored and evaluated for its adhesion preventive effects. A statistically significant adhesion preventive effect has been found compared with the control group.…”

Section: Discussionmentioning

confidence: 99%

Separately and synergistic effects of taurolidine and icodextrin in preventing intraabdominal adhesions

Kurt¹,

Sıkar

Kaptanoğlu³

et al. 2017

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

show abstract

Taurolidine lock is highly effective in preventing catheter-related bloodstream infections in patients on home parenteral nutrition: A heparin-controlled prospective trial

Cited by 108 publications

References 25 publications

In Vitro Assessment of the Antimicrobial Efficacy of Optimized Nitroglycerin-Citrate-Ethanol as a Nonantibiotic, Antimicrobial Catheter Lock Solution for Prevention of Central Line-Associated Bloodstream Infections

In Vitro Assessment of the Antimicrobial Efficacy of Optimized Nitroglycerin-Citrate-Ethanol as a Nonantibiotic, Antimicrobial Catheter Lock Solution for Prevention of Central Line-Associated Bloodstream Infections

Review article: the management of long‐term parenteral nutrition

Separately and synergistic effects of taurolidine and icodextrin in preventing intraabdominal adhesions

Contact Info

Product

Resources

About