Cargando…
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...
Autores principales: | , , , , , , |
---|---|
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 |
_version_ | 1784855385521258496 |
---|---|
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. |
format | Online Article Text |
id | pubmed-9774347 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT blancodimatteoandres preemptiveantimicrobiallocksdecreaselongtermcatheterrelatedbloodstreaminfectionsinhemodialysispatients AT garciafernandeznuria preemptiveantimicrobiallocksdecreaselongtermcatheterrelatedbloodstreaminfectionsinhemodialysispatients AT aguinagaperezaitziber preemptiveantimicrobiallocksdecreaselongtermcatheterrelatedbloodstreaminfectionsinhemodialysispatients AT carmonatorrefrancisco preemptiveantimicrobiallocksdecreaselongtermcatheterrelatedbloodstreaminfectionsinhemodialysispatients AT oteizaamayac preemptiveantimicrobiallocksdecreaselongtermcatheterrelatedbloodstreaminfectionsinhemodialysispatients AT leivajose preemptiveantimicrobiallocksdecreaselongtermcatheterrelatedbloodstreaminfectionsinhemodialysispatients AT delpozojoseluis preemptiveantimicrobiallocksdecreaselongtermcatheterrelatedbloodstreaminfectionsinhemodialysispatients |