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万古霉素封管与 Taurolock 溶液在预防血液透析患者导管相关感染中的比较:一项多中心研究。

Comparison Between Vancomycin Lock and Taurolock Solution for the Prevention of Catheter- related Infections in Hemodialysis Patients, A Multicenter Study.

机构信息

Nephrology Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences Tehran, Iran.

出版信息

Iran J Kidney Dis. 2023 Jul;17(4):215-221.

PMID:37634248
Abstract

INTRODUCTION

Central venous catheters, frequently used in patients undergoing hemodialysis, place the patients at high risk of catheter-related infections. Therefore, it is essential to select the optimal prevention protocol for these infections. This study aims to compare the efficacy of the Taurolock solution and antibiotic lock in preventing tunneled catheter (permcath) related infections.

METHODS

This multicenter study was conducted between June 2020 and July 2021 on 86 hemodialysis patients with a central venous catheter from four dialysis centers in Tehran, Iran. The patients were randomly assigned into two groups. The first group received Taurolock, and the second group received antibiotic lock (a combination of vancomycin and heparin) at the end of each dialysis session. Peripheral blood and catheter blood samples were collected once before the intervention and monthly thereafter, for up to six months, and blood culture performed for detection of various bacterial strains.

RESULTS

The findings showed no significant difference in the infection rate (positive peripheral blood or catheter cultures) between the Taurolock and vancomycin groups (P > .05). Additionally, there was no significant difference in the duration of catheter implantation in individuals with positive and negative cultures (P > .05). Furthermore, no significant correlation was found between comorbidities and catheter-related infection in patients of the two groups (P > .05).

CONCLUSION

There was no significant difference between the two groups in the rate of catheter-related infection. Therefore, vancomycin lock solutions can be good alternatives to Taurolock solution for preventing catheter-related infections.  DOI: 10.52547/ijkd.7615.

摘要

简介

中心静脉导管常用于接受血液透析的患者,使患者面临导管相关感染的高风险。因此,选择最佳的预防方案至关重要。本研究旨在比较 Taurolock 溶液和抗生素封管在预防隧道导管(Permcath)相关感染方面的疗效。

方法

这是一项于 2020 年 6 月至 2021 年 7 月在伊朗德黑兰的四个透析中心进行的多中心研究,共纳入 86 名接受中心静脉导管的血液透析患者。患者被随机分为两组。第一组接受 Taurolock,第二组在每次透析结束时接受抗生素封管(万古霉素和肝素的组合)。在干预前和此后的每月采集一次外周血和导管血样本,持续六个月,进行血培养以检测各种细菌株。

结果

研究结果显示,Taurolock 组和万古霉素组的感染率(外周血或导管培养阳性)无显著差异(P>0.05)。此外,培养阳性和阴性个体的导管植入时间无显著差异(P>0.05)。此外,两组患者的合并症与导管相关感染之间也没有显著相关性(P>0.05)。

结论

两组患者的导管相关感染率无显著差异。因此,万古霉素封管溶液可以作为 Taurolock 溶液预防导管相关感染的良好替代品。DOI:10.52547/ijkd.7615.

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