Management of hemodialysis catheter-related bacteremia with an adjunctive antibiotic lock solution.

摘要: Management of hemodialysis catheter-related bacteremia with an adjunctive antibiotic lock solution. Background Tunneled dialysis catheters are complicated by frequent systemic infections. Standard therapy catheter-associated involves both antibiotics and catheter replacement. Recent data suggest that biofilms in the lumen responsible for bacteremia, instillation (highly concentrated solution) into after sessions can eradicate biofilm. Methods We analyzed prospectively efficacy protocol, conjunction antibiotics, treatment patients without removal. Protocol success was defined as resolution fever negative surveillance cultures one week following completion protocol. failure persistence or positive any pathogen. In addition, infection-free survival compared to observed institutional historical control treated Results Blood were 98 129 episodes (76%) which dialyzing a had chills. occurred 40 79 infected (51%) lock. 39 cases (49%): 7 persistent fever, 15 (9 Candida 6 bacteria), 17 required removal due malfunction. Each pathogens different from original pathogen patient. Eight 9 secondary infections all bacterial resolved exchange specific antimicrobial treatment. Overall protocol similar among managed replacement (median survival, 64 vs. 54 days, P = 0.24). Conclusions Use lock, therapy, while salvaging about half cases. Moreover, this management approach offers clinical advantages over routine exchange.