Taurolidine lock solution in the secondary prevention of central venous catheter-associated bloodstream infection in home parenteral nutrition patients

摘要

Background & aims: Central venous catheter-associated bloodstream infection (CBSI) is a serious complication in patients on home parenteral nutrition (HPN). The aim was to analyze the impact of taurolidine-citrate lock solution (TLS) on CBSI rate in HPN patients with a high risk of catheter infection. Methods: This retrospective study compared CBSI rates 12 months before and 12 months after implementation of TLS. In the first period, only standardized strategies were used to reduce the CBSI rate. In the second period, TLS was injected into the catheter at the end of parenteral nutrition. The CBSI rate with a confident interval was calculated as Poisson event rates, and compared by testing for homogeneity of rates. Results: 15 patients were included. During the 24 months, the CBSI rate was 6.58/1000 catheter-days in the first period and 1.09/1000 catheter-days in the second period (p < 0.001). In patients with TLS once a week (n = 8), the CBSI rate decreased from 4.8/1000 catheter-days to 1.37/1000 catheter-days (p = 0.02) and in patients with TLS after each TPN (n = 7), the CBSI rate decreased from 8.61/1000 catheter-days to 0.78/1000 catheter-days (p = 0.001). Conclusion: In HPN patients, TLS associated with standardized precautions significantly reduced the CBSI rate.