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Pre-Emptive Antimicrobial Locks Decrease Long-Term Catheter-Related Bloodstream Infections in Hemodialysis Patients

This study aimed to prove that pre-emptive antimicrobial locks in patients at risk of bacteremia decrease infection. We performed a non-randomized prospective pilot study of hemodialysis patients with tunneled central venous catheters. We drew quantitative blood cultures monthly to detect colonizati...

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Autores principales: Blanco-Di Matteo, Andres, Garcia-Fernandez, Nuria, Aguinaga Pérez, Aitziber, Carmona-Torre, Francisco, Oteiza, Amaya C., Leiva, Jose, Del Pozo, Jose Luis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9774347/
https://www.ncbi.nlm.nih.gov/pubmed/36551349
http://dx.doi.org/10.3390/antibiotics11121692
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author Blanco-Di Matteo, Andres
Garcia-Fernandez, Nuria
Aguinaga Pérez, Aitziber
Carmona-Torre, Francisco
Oteiza, Amaya C.
Leiva, Jose
Del Pozo, Jose Luis
author_facet Blanco-Di Matteo, Andres
Garcia-Fernandez, Nuria
Aguinaga Pérez, Aitziber
Carmona-Torre, Francisco
Oteiza, Amaya C.
Leiva, Jose
Del Pozo, Jose Luis
author_sort Blanco-Di Matteo, Andres
collection PubMed
description This study aimed to prove that pre-emptive antimicrobial locks in patients at risk of bacteremia decrease infection. We performed a non-randomized prospective pilot study of hemodialysis patients with tunneled central venous catheters. We drew quantitative blood cultures monthly to detect colonization. Patients with a critical catheter colonization by coagulase-negative staphylococci (defined as counts of 100–999 CFU/mL) were at high risk of developing a catheter-related bloodstream infection. We recommended antimicrobial lock for this set of patients. The nephrologist in charge of the patient decided whether to follow the recommendation or not (i.e., standard of care). We compared bloodstream infection rates between patients treated with antimicrobial lock therapy versus patients treated with the standard of care (i.e., heparin). We enrolled 149 patients and diagnosed 86 episodes of critical catheter colonization by coagulase-negative staphylococci. Patients treated with antimicrobial lock had a relative risk of bloodstream infection of 0.19 when compared with heparin lock (CI 95%, 0.11–0.33, p < 0.001) within three months of treatment. We avoided one catheter-related bloodstream infection for every ten catheter-critical colonizations treated with antimicrobial lock [number needed to treat 10, 95% CI, 5.26–100, p = 0.046]. In conclusion, pre-emptive antimicrobial locks decrease bloodstream infection rates in hemodialysis patients with critical catheter colonization.
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spelling pubmed-97743472022-12-23 Pre-Emptive Antimicrobial Locks Decrease Long-Term Catheter-Related Bloodstream Infections in Hemodialysis Patients Blanco-Di Matteo, Andres Garcia-Fernandez, Nuria Aguinaga Pérez, Aitziber Carmona-Torre, Francisco Oteiza, Amaya C. Leiva, Jose Del Pozo, Jose Luis Antibiotics (Basel) Article This study aimed to prove that pre-emptive antimicrobial locks in patients at risk of bacteremia decrease infection. We performed a non-randomized prospective pilot study of hemodialysis patients with tunneled central venous catheters. We drew quantitative blood cultures monthly to detect colonization. Patients with a critical catheter colonization by coagulase-negative staphylococci (defined as counts of 100–999 CFU/mL) were at high risk of developing a catheter-related bloodstream infection. We recommended antimicrobial lock for this set of patients. The nephrologist in charge of the patient decided whether to follow the recommendation or not (i.e., standard of care). We compared bloodstream infection rates between patients treated with antimicrobial lock therapy versus patients treated with the standard of care (i.e., heparin). We enrolled 149 patients and diagnosed 86 episodes of critical catheter colonization by coagulase-negative staphylococci. Patients treated with antimicrobial lock had a relative risk of bloodstream infection of 0.19 when compared with heparin lock (CI 95%, 0.11–0.33, p < 0.001) within three months of treatment. We avoided one catheter-related bloodstream infection for every ten catheter-critical colonizations treated with antimicrobial lock [number needed to treat 10, 95% CI, 5.26–100, p = 0.046]. In conclusion, pre-emptive antimicrobial locks decrease bloodstream infection rates in hemodialysis patients with critical catheter colonization. MDPI 2022-11-24 /pmc/articles/PMC9774347/ /pubmed/36551349 http://dx.doi.org/10.3390/antibiotics11121692 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Blanco-Di Matteo, Andres
Garcia-Fernandez, Nuria
Aguinaga Pérez, Aitziber
Carmona-Torre, Francisco
Oteiza, Amaya C.
Leiva, Jose
Del Pozo, Jose Luis
Pre-Emptive Antimicrobial Locks Decrease Long-Term Catheter-Related Bloodstream Infections in Hemodialysis Patients
title Pre-Emptive Antimicrobial Locks Decrease Long-Term Catheter-Related Bloodstream Infections in Hemodialysis Patients
title_full Pre-Emptive Antimicrobial Locks Decrease Long-Term Catheter-Related Bloodstream Infections in Hemodialysis Patients
title_fullStr Pre-Emptive Antimicrobial Locks Decrease Long-Term Catheter-Related Bloodstream Infections in Hemodialysis Patients
title_full_unstemmed Pre-Emptive Antimicrobial Locks Decrease Long-Term Catheter-Related Bloodstream Infections in Hemodialysis Patients
title_short Pre-Emptive Antimicrobial Locks Decrease Long-Term Catheter-Related Bloodstream Infections in Hemodialysis Patients
title_sort pre-emptive antimicrobial locks decrease long-term catheter-related bloodstream infections in hemodialysis patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9774347/
https://www.ncbi.nlm.nih.gov/pubmed/36551349
http://dx.doi.org/10.3390/antibiotics11121692
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