Use of an ethanol lock to prevent catheter-related infections in children with short bowel syndrome

Mouw, Elisabeth; Chessman, Katherine; Lesher, Aaron; Tagge, Edward P.

doi:10.1016/j.jpedsurg.2008.02.026

Cited by 118 publications

(137 citation statements)

References 14 publications

(25 reference statements)

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“…In addition, these same data suggest possible but significant complications with ethanol lock use, including catheter thrombosis, which has precluded its more widespread use ( Table 1). [13][14][15][16][17][18] In an attempt to reduce CCABSI infections in our patients and improve clinical outcomes, we performed a qualityimprovement (QI) initiative intended to evaluate whether the addition of ELP to our CCABSI prevention bundle in both the hospital and home settings could safely reduce CCABSI rates in our pediatric patients with IF.…”

mentioning

confidence: 99%

Central Catheter–Associated Bloodstream Infection Reduction With Ethanol Lock Prophylaxis in Pediatric Intestinal Failure

et al. 2015

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mentioning

confidence: 99%

Central Catheter–Associated Bloodstream Infection Reduction With Ethanol Lock Prophylaxis in Pediatric Intestinal Failure

et al. 2015

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“…También se ha comunicado casos de complicaciones más graves como coagulación intravascular diseminada o trombosis venosa profunda (33,34,36). De hecho, existe cierta controversia sobre si el etanol incrementa el riesgo de trombosis u oclusión del catéter.…”

Section: Etanolunclassified

Sellado con antibióticos o antisépticos en pacientes pediátricos con nutrición parenteral domiciliaria. Puesta al dí

et al. 2016

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Introduction: Home parenteral nutrition has become the mainstay for the support of patients with severe chronic intestinal failure. Despite the signifi cant advances that have occurred in recent decades in terms of vascular access and parenteral solutions, catheter-related bloodstream infections remain one of the most important complications. Antiseptic lock therapies, as ethanol or taurolidine; and antibiotic lock therapies are used in order to prevent or treat these infections. Objective: The aim of this article is to review the available scientifi c evidence regarding the use of antiseptic and antibiotic lock therapies in the management of pediatric patients with home parenteral nutrition. Material and methods: The use of ethanol or taurolidine lock therapy would be suggested in order to prevent catheter-related bloodstream infections in patients with home parenteral nutrition who have suffered from more than one infection in the previous year or in at-risk patients. Antibiotic locks are used for the treatment of catheter-related bloodstream infections due to S. coagulase negative and gram-negative bacilli in conjunction with systemic antimicrobial therapy, for whom catheter salvage is the goal. Catheter removal is recommended when there are signs of exit site or tunnel infection or the infection is due to S. aureus or Candida species. Conclusion: Despite the fact that evidence based data on the topic is scarce, there are a growing number of publications that support the use of antibiotics or antiseptic locks for the prevention or treatment of catheter-related infections in home parenteral nutrition patients, in whom catheter maintenance is a cornerstone for survival.

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“…excelsiormedical.com). Furthermore, recent studies have shown a benefit from ELT in treating and preventing CRBIs (Bookstaver et al, 2010;Broom et al, 2009;Cober et al, 2011;Mouw et al, 2008;Sanders et al, 2008). As a result of broad interest in ELT at the Nebraska Medical Center, Maiefski et al (2009) devised ELT recommendations for prevention and treatment of CRBSI based on the findings in their review.…”

Section: Ethanol- Edta-and Levofloxacin-based Clsmentioning

confidence: 99%

“…Our results suggest that ethanol at low concentrations, alone or in combination with a chelator, used as a CLS for short periods (1-4 h) could decontaminate the line in CRBSIs due to S. maltophilia and, in conjunction with systemic antibiotics, help to retain precious vascular catheters. Clinical studies using ELT reported mild or no adverse effects (Broom et al, 2008;Dannenberg et al, 2003;Mouw et al, 2008;Onland et al, 2006;Sanders et al, 2008). Some mild adverse events have been reported in children in ELT studies using 70 % ethanol, including tiredness, headaches, dizziness, nausea and light-headedness (Dannenberg et al, 2003).…”

Section: Ethanol- Edta-and Levofloxacin-based Clsmentioning

confidence: 99%

Comparative in vitro efficacies of ethanol-, EDTA- and levofloxacin-based catheter lock solutions on eradication of Stenotrophomonas maltophilia biofilms

Rossi

Feldman

Pineda

et al. 2012

Journal of Medical Microbiology

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The aim of this study was to compare the in vitro activity of ethanol, EDTA and levofloxacin (Levo), alone or in combination, on biofilms of Stenotrophomonas maltophilia recovered from patients with catheter-related bloodstream infections (CRBSIs) at a university hospital in Argentina. First, 24 and 48 h biofilms were formed in microtitre plates and challenged with 25 or 40 % ethanol for 1 h. Biofilms, of the 14 local isolates and from the reference strain K279a, were eradicated after both treatments as shown by plate counts and the regrowth technique. Second, 24 h biofilms of all isolates were established in silicone catheter segments and challenged with 25 or 40 % ethanol, Levo (2.5 mg ml ), 25 % ethanol-EDTA or Levo-EDTA for 1, 3 and 24 h. Viable counts of biofilms treated for 1 h with 25 or 40 % ethanol or 25 % ethanol-EDTA were under the limit of detection. Killing of biofilms by Levo or Levo-EDTA was gradual and it was only after 24 h of treatment that no differences could be seen between the effects of these catheter lock solutions (CLSs) and those of ethanol (P.0.05). Levo-EDTA, in combination, did not act synergistically against biofilms. After 24 h of exposure, EDTA did not eradicate biofilms but reduced biofilm survival rates to 1-5 %. The effect of the different CLSs on biomass reduction, estimated by crystal violet staining, was highly dependent on the isolate, and the most effective agents were 25 and 40 % ethanol. Our results suggest that when used as a CLS for short periods, ethanol at low concentrations, alone or in combination with a chelator, can decontaminate the line from S. maltophilia in cases of CRBSI and help, in conjunction with systemic antibiotics, in the retention of precious vascular catheters.

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Use of an ethanol lock to prevent catheter-related infections in children with short bowel syndrome

Cited by 118 publications

References 14 publications

Central Catheter–Associated Bloodstream Infection Reduction With Ethanol Lock Prophylaxis in Pediatric Intestinal Failure

Central Catheter–Associated Bloodstream Infection Reduction With Ethanol Lock Prophylaxis in Pediatric Intestinal Failure

Sellado con antibióticos o antisépticos en pacientes pediátricos con nutrición parenteral domiciliaria. Puesta al dí

Comparative in vitro efficacies of ethanol-, EDTA- and levofloxacin-based catheter lock solutions on eradication of Stenotrophomonas maltophilia biofilms

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