Skip to main content Accessibility help

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

  • Anthony J. Bleyer (a1), Lori Mason (a1), Gregory Russell (a2), Issam I. Raad (a3) and Robert J. Sherertz (a1)...


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.


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.


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.


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).


Corresponding author

Section on Nephrology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC


Hide All
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.
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.
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.
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.
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.
6.Beathard, GA. Catheter thrombosis. Semin Dial 2001;14:441445.
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.
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.
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.
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.
11.Allon, M. Prophylaxis against dialysis catheter-related bacteremia with a novel antimicrobial solution. Clin Infect Dis 2003;36:15391544.
12.Maki, DG, Weise, CE, Sarafin, HW. A semiquantitative culture method for identification of catheter-related infection. N Engl J Med 1997;296: 13051309.
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.
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.
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.
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.


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed