Taurolidine-citrate-heparin catheter lock solution reduces staphylococcal bacteraemia rates in haemodialysis patients

Murray, E.C., Deighan, C., Geddes, C. and Thomson, P.C. (2014) Taurolidine-citrate-heparin catheter lock solution reduces staphylococcal bacteraemia rates in haemodialysis patients. QJM: An International Journal of Medicine, 107(12), pp. 995-1000. (doi: 10.1093/qjmed/hcu128)

Abstract

Background: Infection is second only to cardiovascular disease as a cause of death in the haemodialysis (HD) population.<p></p> Aim: To assess the effect of introducing catheter lock solution taurolidine–citrate–heparin to all tunnelled central venous catheters (TCVCs) on staphylococcal bloodstream infection rates in patients on chronic HD.<p></p> Design: Observational, prospective analysis of the incidence rates of staphylococcal bacteraemic events in National Health Service (NHS) Greater Glasgow & Clyde and NHS Forth Valley between April 2011 and June 2013, with taurolidine–citrate–heparin catheter lock solution introduced July 2012.<p></p> Methods: Data were collected each calendar quarter through a structured query language interrogation of the renal unit electronic patient record, with staphylococcal bacteraemic events expressed per 1000 vascular access exposed days. Comparison between pre- and post-intervention periods was made by student’s t-testing.<p></p> Results: Two hundred and thirty-nine staphylococcal bacteraemic events occurred over a total of 424 835 HD days in 565 patients; 81 events in 289 389 arterio-venous fistula or graft (AVF/AVG) HD days and 158 events in 135 446 TCVC HD days. Following the introduction of taurolidine–citrate–heparin, bacteraemic events in patients dialysing via a TCVC fell from 1.59/1000 HD days to 0.69/1000 HD days, P = 0.004. The staphylococcal bacteraemia rate in AVF/AVGs remained unchanged; 0.30 vs. 0.26/1000 HD days, P = 0.52.<p></p> Conclusions: Replacing heparin 5000 IU with Taurolidine–citrate–heparin as catheter lock solution was associated with a statistically significant 56% reduction in staphylococcal bloodstream infection rates in our TCVC HD population.<p></p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Thomson, Dr Peter and Geddes, Dr Colin and Murray, Dr Eleanor
• Authors: Murray, E.C., Deighan, C., Geddes, C., and Thomson, P.C.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: QJM: An International Journal of Medicine
• Publisher: Oxford University Press
• ISSN: 1460-2725
• ISSN (Online): 1460-2393