International experience with minocycline, EDTA and ethanol lock for salvaging of central line associated bloodstream infections. (3rd June 2018)

• Record Type: Journal Article
• Authors: Hachem, Ray; Kanj, Souha; Hamerschlak, Nelson; Saad, Hala; Assir, Fernanda Ferraz; Mori, Nobuyoshi; Jiang, Ying; Ghaly, Fady; Chaftari, Anne Marie; Raad, Issam I
• Is Part Of: Expert review of medical devices. Volume 15:Number 6(2018)
• Page Start: 461
• Page End: 466
• Publication Date: 2018-06-03
• Subjects: EDTA -- ethanol lock -- central catheters -- central line associated -- bloodstream infections -- minocycline; Medical instruments and apparatus -- Periodicals; 610.28
• DOI: 10.1080/17434440.2018.1483237
• Languages: English
• ISSNs: 1743-4440

Abstract

ABSTRACT: Background : The use of long-term central venous catheters (CVCs) could lead to serious bloodstream infections. Removal of the infected CVC and reinsertion of a new CVC are not always feasible and alternative lock therapy may be considered. We conducted a multicenter trial to assess the efficacy and safety of the lock therapy. Methods : Between October 2013 and August 2014, we prospectively enrolled 20 patients with catheter-related bloodstream infections (CRBSIs) or central line-associated bloodstream infections (CLABSIs) in our sister institutions in three countries including Brazil, Lebanon, and Japan. The 20 patients who received M-EDTA-EtOH lock therapy were compared to 24 control patients who had their CVCs removed and a new CVC inserted. Results : Both groups had comparable clinical characteristics. In the lock therapy group, 95% of the patients had microbiological eradication within 96 h after starting lock therapy versus 83% of the patients in the control group ( p = .36). In the lock group, the CVC was salvaged and retained for a median of 21 days (range 7–51) from the onset of bacteremia. Conclusion : Our study suggests that M-EDTA-EtOH lock therapy may be an effective intervention to salvage long-term CVCs in the setting of CLABSI/CRBSI and hemodialysis cancer patients with limited vascular access.