Al-Hwiesh Abdulla K, Abdul-Rahman Ibrahiem Saeed
Department of Internal Medicine, Nephrology Division, King Fahd Hospital of the University, King Faisal University, Al-Khobar, Saudi Arabia.
Saudi J Kidney Dis Transpl. 2007 Jun;18(2):239-47.
Tunneled, cuffed central vein catheters (TCC) are widely used for delivering hemodialysis (HD). Among the complications associated with central vein catheters in HD patients, infection is the principal cause of morbidity and mortality. The optimal strategy for management of TCC infections is unclear. This prospective study was aimed at assessing the efficacy of antibiotic-lock therapy using vancomycin and gentamycin in preventing catheter-related blood stream bacterial infection in patients on HD. A total of 63 HD patients with 81 TCC were enrolled at the time of catheter insertion. Patients were randomized into two groups: Group I (33 patients, 37 insertions) included TCC with antibiotic lock therapy and Group II (30 patients, 44 insertions) with routine TCC management. Infection-free catheter survival of both groups was evaluated and compared at the end of the 12-month study period. A total of 57 TCC infections were encountered with an incidence rate of 8.95 infections per 1000 dialysis sessions (DS). The rate of infection was significantly lower in Group I (4.54 per 1000 DS) as compared to Group II (13.11 per 1000 DS), p 0.05). Our study suggests that antibiotic-lock therapy using a combination of vancomycin and gentamycin is useful in preventing catheter-related blood stream infection in patients on HD.
带隧道带涤纶套的中心静脉导管（TCC）广泛用于进行血液透析（HD）。在血液透析患者中与中心静脉导管相关的并发症中，感染是发病和死亡的主要原因。TCC感染的最佳管理策略尚不清楚。这项前瞻性研究旨在评估使用万古霉素和庆大霉素的抗生素封管疗法在预防血液透析患者导管相关血流细菌感染方面的疗效。共有63例接受81根TCC的血液透析患者在导管插入时入组。患者被随机分为两组：第一组（33例患者，37次插入）包括接受抗生素封管疗法的TCC，第二组（30例患者，44次插入）采用常规TCC管理。在12个月的研究期结束时评估并比较两组无感染导管的存活情况。共发生57例TCC感染，发生率为每1000次透析疗程（DS）8.95次感染。与第二组（每1000次DS 13.11次）相比，第一组的感染率（每1000次DS 4.54次）显著更低（p<0.05）。我们的研究表明，联合使用万古霉素和庆大霉素的抗生素封管疗法有助于预防血液透析患者的导管相关血流感染。
