Effect of vancomycin as antibiotic lock technique in prevention of catheter associated infection in stem cell transplantation patients Vancomycin lock after HSCT
International Pharmacy Acta,
Vol. 4 No. 1 (2021),
2 June 2021
,
Page 4e10:1-8
https://doi.org/10.22037/ipa.v4i1.35723
Abstract
Introduction: This trial assessed the efficacy of vancomycin lock solution in reducing catheter-related blood stream infections among bone marrow transplantation patients who were transplanted using tunneled catheters.
Methods and Results: patients randomly received either heparin only (control group) or a mixture of 5 mg/ml vancomycin and 2500 U/ml heparin (antibiotic group) as catheter lock solution. Results: The control group, CRBSIs rates per1000 catheter-days was significantly lower (0.1609 vs 6.214 events; p=0.0265, Hazard ratio 4.924 %95 CI of ratio1.238-31.20) and BSI (Blood Stream Infection) rates per 1000 catheter-days was significantly lower (0.2744vs 3.644events; p=0.0073, Hazard ratio 7.209 %95 CI of ratio (0.03205-0.808)). More over, The cumulative infection-free catheter survival was significantly higher (log rank statistic 4.924 p=0.0265) in the antibiotic group and cumulative infection-free survival was significantly higher (log rank statistic 7.209 p=0.0073) in the antibiotic group compared with the control group. There is no significant difference in catheter removal incidence (27.27% in the antibiotic group vs 15.38% in the control group; p=0.245) between the two group.
Conclusion: Vancomycin containing catheter lock solution is effective in reducing CRBSIs incidence and prolonging central vein catheter survival in Hematopoietic stem cell transplantation (HSCT) patients.
- Vancomycin
- Catheter-Related Infections
- Bone Marrow Transplantation
How to Cite
References
Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with differernt intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc 2006;81;1159.
O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011;52:e162.
Berenholtz SM, Lubomski LH, Weeks K,et al. Eliminating central line-associated bloodstream infections: a national patient safety imperative. Infect Control Hosp Epidemiol 2014;35:56.
Centers for Disease Control and Prevention. Helathcare-associated Infections (HAI) Progress Report. http://www.cdc.gov/hai/progress-report/index.html(Accessed on January 03,2018).
Centers for Disease Control and Prevention(CDC). Vital Signs. Making Health Care Safer: Reducing Bloodstream Infections. Available from: http://www.cdc.gov/VitalSigns/pdf/2011-03-vitalsigns.pdf. Accessed May 10,2014.
Dudeck MA, Weiner LM, Allen-Bridson K, et al. National Helathcare Safety Network (NHSN) report, data summary for 2012, Device-associated module. Am J Infect Control.2013;41(12):1148-1166.
Centers for Disease Control and Prevention(CDC). Vital Signs: Central line-associated bloodstream infections-United States,2001,2008,and 2009.MM20WR Morb Mortal Wkly Rep.2011;60(8):243-248.
Centers for Disease Control and Prevention(CDC), Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011. Atlanta,GA: Centers for Disease Control and Prevention; 2011. Available from:http://wwww.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf. Accessed May 10, 2014.
Mermel LA, Allin M, Bouza E,et al. Clinical practice guidlines for the diagnosis and managment of intravascular catheter-related infection:2009 Update by the Infections Diseases Society of America. Clin Infect Dis.2009;49(1):1-45.
Costerton JW, Lewandowski Z, Debeer D, Caldwall D, Korber D, James G. Biofilms,the customized microniche.J Bacteriol 1994;176(8):2137-2142.
Jefferson KK, Goldmann DA, Pier GB. Use of confocal microscopy to analyze the rate of vancomycin penetration through Staphylococcus aureus biofilms. Antimicrob Agents Chemother, 2005;49(6): 2467-2473.
Mermel LA, Allon M, Bouza E,et al. Clinical practice guidlines for the diagnosis and managment of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis.2009;49(1):1-45.
Maiefski M, Rupp ME, Hermsen ED.Ethanol lock technique: review of the literature. Infect Control Hosp Epidemiol. 2009;30(11):1096-1108.
Jaffer Y,Selby NM, Taal MW, Fluck RJ, McIntyre CW. A meta-analysis of hemodialysis catheter locking solutions in the prevention of catheter-related infection. AM J Kidney Dis. 2008;51(2):223-241.
O’Horo JC, Sliva GL, Safdar N. Anti-infective locks for treatment of central line-associated bloodstream infection: a systematic review and meta-analysis. Am J Nephrol.2011;34(5):415-422.
Polgreen PM, Beekmann SE, Dickema DJ, Sheretz RJ. Wide variability in the use of antimicrobial lock therapy and prophylaxis among infectious diseases consultants. Infect Control Hosp Epidemiol.2010;31(5):554-557.
Messing B, Man F, Colimon R, Thuillier F, Beliah M. Antibiotic-lock technique in affective treatment of bacterial catheter-related sepsis during parenteral nutrition. Clin Nutr. 1990;9(4):220-225.
Stand ford Hospital and Clinics,Pharmacy Department Policies and Procedures /Antibiotic Lock Therapy Guideline. Issue date:06/2011. Review/Revise Date:01/2015
National Healthcare Safety Network. Bloodstream Infection Event (Central Line-Associated Bloodstream Infection and Non-Central Line-Associated Blood stream Infection). http://www.cdc.gov/nhsn/PDFs/pscManual/4PSC_CLABScurrent.pdf(Accessed on November 16,2015).
Maki, DG, Mermel, LA. Infections due to infusion therapy. In: Hospital infections, Bennett JV, Brachman PS(EDS), Lippincott-Raven, Philadelphia, PA 1998. P.689-724.
Safdar N, Maki DG. Inflammtion at the Insertion site is not predictive of catheter-related bloodstream infection with short-term, noncuffed central venous catheters. Crit Care Med 2002; 30:2632.
Pearson ML. Guidline for prevention of intravascular device-related infections. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1996; 17:438-73. Reporduced with permission from: Mermel, LA, Allon, M, Bouza, E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 uptodate by the Infectious Disease Society of America. Clin Infect Dis 2009;49:1.
Segarra-Newmham M, Martin-Cooper EM. Antibiotic locktechnique: a review of the literature.Ann pharmacother. 2005;39(2):311-318.
Fernandez-Hidalgo N, Almirante B, Calleja R, et al. Antibiotic-lock therapy for long-term intravascular catheter-related bacteraemia: results of an open, non-comparative study. J Antimicrob Chemother. 2006;57(6):1172-1180.
Snydman DR, Gorbea HF, Pober BR, et al. Predictive value of surveillance skin culturs in total –parenteral-nutrition-related infection. Lancet 1982;2:1385.
Bjornson HS, Colley R, Bower RH, et al. Association between microorganism growth at the catheter insertion site and colonization of the catheter in patients receiving total parenteral nutrition. Surgery 1982; 92:720.
Cooper GL, Hopkins CC. Rapid diagnosis of the intravascular catheter-associated infection by direct Gram staining of catheter segments. N Engl J Med 1985; 312:1142.
Raad II, Baba M, Bodey GP. Diagnosis of catheter-related infections: the role of surveillance and targeted quantitative skin cultures. Clin Infect Dis 1995; 20:593.
Guidet B, Nicola I, Barakett V, et al. Skin versus hub cultures to predict colonization and infection of central venous catheter in tensive care patients. Infection 1994;22:43.
Armstrong CW, Mayhall CG, Miller KB, et al. Clinical perdictors of infection of central venous catheter used for total parenteral nutrition. Infect Control Hosp Epidemiol 1990;11:71.
Raad I, Costerton W, Sabharwal U, et al. Ultrastrutural analysis of indwelling vascular catheters: a quantitive relationship between luminal colonization and duration of placement. J Infect Dis 1993; 168:400.
Liñares J, Sitges-Serra A, Garau J, et al. Pathogenesis of catheter sepsis: a prospective study with quantitative and semiquentitative cultures of catheter hub and segments. J Clin Microbiol 1985:21:357.
Tenney JH, Moody MR, Newman KA, et al. Adherent microorganisms on luminal surfaces of long-term intravenous catheters. Importance of Staphylococcus epidermidis in patients with cancer. Arch Intern Med 1986; 146:1949.
Miller JJ, Venus B, Mathru M. Comparison of the sterility of long-term central venous catheterization using single lumen, triple lumen, and pulmonary artery catheters. Crit Care Med 1984; 12:634.
Salzman MB, Isenberg HD, Shapiro JF, et al. A prospective study of the catheter hub as the portal of entry for microorganisms causing catheter-related sepsis in neonates. J Infect Dis 1993; 167:487.
Moghaddas A, Abbasi MR, Gharekhani A, Dashti-Khavidaki S, Razeghi E, Jafari A, Khalili H. Prevention of hemodialysis catheter-related blood stream infections using a cotrimoxazole-lock technique. Future Microbiol. 2015;10(2):169-78. doi: 10.2217/fmb.14.116.
weijmer mc ,van den Dorpel Ma,Van de VenPJetal.Randomized,clinical trial comparison of trisodium citrate30 %and heparin as catheter-lock solution in hemodialysis patients.J.Am.Soc.Nephrol.16(9),2769-2777(2005
AndrisDA,Krzywda EA,Edmiston CE,Krepel CJ,GohrCM,Elimination of intraluminal colonization by antibiotic lock in silicone vascular catheter,Nutrition 14(5),427-432(1998).
O’Horo JC, Silva GL,Safadr N. Anti-infective locj for treatment of central line-associated bloodstream infection: a systematic review and meta-analysis. Am J Nephrol 2011; 34:415.
Messing B, Peitra-Cohen S, Debure A, et al. Antibiotic-lock technique: a new approach to optimal therapy for catheter-related sepsis in home-parenteral nutrition patients. JPEN J Parenter Enteral Nutr 1988; 12:185.
Chatzinikolaou I, Zipf TF, Hanna H,et al. Minocycline-ethylene-diaminetetraacetate lock solution for the prevention of implantable port infection in children with cancer. Clin Infect Dis. 2003;36(1):116-119.
Feely T, Copley A, Bleyer AJ. Catheter lock solutions to prevent blood stream infections in high-risk hemodialysis patients. Am J Nephrol.2007;27(1):24-29.
Abbas SA, Haloob IA, Taylor SL,et al.Effect of antimicrobial locks for tuuneled hemodialysis catheters on blood stream infection and bacterial resistance: a quality improvement report. Am J Kidney Dis. 2009;53(3):492-502.
Landry DL, Braden GL, Gobeille SL,Haessler SD, Vaidya CK, Sweet SJ. Emergence of gentamycin-resistant bacteremia in hemodialysis patients receiving gentamycin lock catheter prophylaxis. Clin J Am Soc Nephrol.2010;5(10):1799-1804.
Rosenthal VD, Bijie H, Maki DG, et al. International Nosocominal Infection Control Consortium (INICC) report, data summary of 36 countries for 2004-2009. Am J Infect Control 2012; 40:396.
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