Skip to main content Accessibility help
×
Home
Hostname: page-component-559fc8cf4f-6f8dk Total loading time: 0.51 Render date: 2021-03-05T07:59:32.325Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false, "newCitedByModal": true }

A Randomized, Controlled Trial of a New Vascular Catheter Flush Solution (Minocycline-EDTA) in Temporary Hemodialysis Access

Published online by Cambridge University Press:  21 June 2016

Anthony J. Bleyer
Affiliation:
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Lori Mason
Affiliation:
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Gregory Russell
Affiliation:
Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Issam I. Raad
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, Texas
Robert J. Sherertz
Affiliation:
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Corresponding
E-mail address:

Abstract

Background and Objective:

We previously demonstrated that minocycline-EDTA was efficacious at preventing catheter-related bloodstream infections (BSIs) in three patients with recurrent infections. This study compared heparin with minocycline-EDTA as flush solutions used among dialysis patients with central venous catheters, a high-risk group for catheter-related BSI.

Methods:

Patients were enrolled within 72 hours of catheter insertion and randomized to receive heparin or minocycline-EDTA as a flush after each dialysis session. Each syringe containing flush solution was wrapped in orange plastic to conceal the type of solution it contained. Patients were observed for evidence of infection and catheter thrombosis. After catheters were removed, cultures were performed to determine whether microbial colonization had occurred.

Results:

During a 14-month period, 60 patients were enrolled (30 in each group). The two groups had similar demographics and underlying diseases. Catheter survival at 90 days was 83% for the minocycline-EDTA group versus 66% for the heparin group (P = .07). Significant catheter colonization, a surrogate measure of catheter-related infection, was significantly more frequent in the heparin group (9 of 14 vs 1 of 11; P= .005). There was only one catheter-related bacteremia and it occurred in the heparin group.

Conclusions:

When compared with heparin, minocycline-EDTA had a better 90-day catheter survival (P = .07) and a decreased rate of catheter colonization. This pilot study warrants a larger prospective, randomized trial (Infect Control Hosp Epidemiol 2005;26:520-524).

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

Access options

Get access to the full version of this content by using one of the access options below.

References

1.Hoen, B, Kessler, M, Hestin, D, Mayeux, D. Risk factors for bacterial infections in chronic haemodialysis adult patients: a multicentre prospective survey. Nephrol Dial Transplant 1995;10:377381.Google ScholarPubMed
2.Hoen, B, Paul-Dauphin, A, Hestin, D, Kessler, M. EPIBACDIAL: a multicenter prospective study of risk factors for bacteremia in chronic hemodialysis patients. J Am Soc Nephrol 1998;9:869876.Google Scholar
3.Taylor, GD, McKenzie, M, Buchanan-Cheli, M, Caballo, L, Chui, L, Kowalewska-Grochowska, K. Central venous catheters as a source of hemodialysis-related bacteremia. Infect Control Hosp Epidemiol 1998;19:643646.CrossRefGoogle ScholarPubMed
4.Stevenson, KB, Adcox, MJ, Mallea, MC, Narasimhan, N, Wagnild, JP. Standardized surveillance of hemodialysis vascular access infections: 18-month experience at an outpatient, multifacility hemodialysis center. Infect Control Hosp Epidemiol 2000;21:200203.CrossRefGoogle ScholarPubMed
5.Tokars, JI, Light, P, Anderson, J, et al.A prospective study of vascular access infections at seven outpatient hemodialysis centers. Am J Kid Bis 2001;37:12321240.CrossRefGoogle ScholarPubMed
6.Beathard, GA. Catheter thrombosis. Semin Dial 2001;14:441445.CrossRefGoogle ScholarPubMed
7.Sherertz, RJ. Pathogenesis of vascular catheter infections. In: Seifert, H, Jansen, B, Farr, BM, eds. Catheter-Related Infections. New York: Marcel Dekker; 1997:129.Google Scholar
8.Raad, I, Buzaid, A, Rhyne, J, et al.Minocycline and EDTA for the prevention of recurrent vascular catheter infections. Clin Infect Dis 1997;25:149151.CrossRefGoogle ScholarPubMed
9.Chatzinikolaou, I, Zipf, TF, Hanna, H, et al.Minocycline-ethylenediami-netetraacetate lock solution for the prevention of implantable port infections in children with cancer. Clin Infect Dis 2003;36:116119.CrossRefGoogle ScholarPubMed
10.Dogra, GK, Herson, H, Hutchison, B, et al.Prevention of tunneled hemodialysis catheter-related infections using catheter-restricted filling with gentamicin and citrate: a randomized controlled study. J Am Soc Nephrol 2002;13:21332139.CrossRefGoogle ScholarPubMed
11.Allon, M. Prophylaxis against dialysis catheter-related bacteremia with a novel antimicrobial solution. Clin Infect Dis 2003;36:15391544.CrossRefGoogle Scholar
12.Maki, DG, Weise, CE, Sarafin, HW. A semiquantitative culture method for identification of catheter-related infection. N Engl J Med 1997;296: 13051309.CrossRefGoogle Scholar
13.Sherertz, RJ, Heard, SO, Raad, II. Diagnosis of triple-lumen catheter infection: comparison of roll plate, sonication, and flushing methodologies. J Clin Microbiol 1997;35:641646.Google ScholarPubMed
14.Sherertz, RJ, Raad, II, Belani, A, et al.Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory. J Clin Microbiol 1990;28:7682.Google Scholar
15.Capdevila, JA, Planes, AM, Palomar, M, et al.Value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis. Eur J Clin Microbiol Infect Dis 1992;11:403407.CrossRefGoogle Scholar
16.Rijinders, BJA, Van Wijngaerden, E, Peetermans, WE. Catheter-tip colonization as a surrogate end point in clinical studies on catheter-related bloodstream infection: how strong is the evidence? Clin Infect Dis 2002;35:10531058.CrossRefGoogle Scholar

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 0
Total number of PDF views: 7 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 5th March 2021. This data will be updated every 24 hours.

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

A Randomized, Controlled Trial of a New Vascular Catheter Flush Solution (Minocycline-EDTA) in Temporary Hemodialysis Access
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

A Randomized, Controlled Trial of a New Vascular Catheter Flush Solution (Minocycline-EDTA) in Temporary Hemodialysis Access
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

A Randomized, Controlled Trial of a New Vascular Catheter Flush Solution (Minocycline-EDTA) in Temporary Hemodialysis Access
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *