Calabrese Vincenzo, Farina Alessandra, Maressa Veronica, Cernaro Valeria, Gembillo Guido, Messina Roberta Maria, Longhitano Elisa, Ferio Cinzia, Venanzi Rullo Emanuele, Santoro Domenico
Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University Hospital "G. Martino", University of Messina, 98124 Messina, Italy.
Department of Clinical and Experimental Medicine, CDS Medicina e Chirurgia, University of Messina, 98124 Messina, Italy.
Clin Pract. 2024 Aug 9;14(4):1538-1549. doi: 10.3390/clinpract14040124.
: Central Venous Catheter (CVC)-related infections cannot always be solved by replacement, due to some vascular anomalies or an emergency status. This comprehensive, evidence-based review aimed to define the efficacy of antibacterial lock therapy (ALT) compared to the standard of care (SoC) in CVC-related infections. : We performed a systematic search in PubMed, Embase, and Google Scholar, looking for randomized controlled trials (RCTs) and cohort or case-control observational studies. The eligible studies considered the subjects with a diagnosis of CVC-related infections treated with antibacterial lock therapy (ALT) compared to the standard of care (SoC). Among 609 records at the end of the selection process, five articles, referring to observational studies, were included in this systematic review. In pooled analyses, including a total of 276 individuals, microbiological healing (OR 3.78; 95% CI; 2.03-7.03) showed significant differences between ALT and the SoC, with a follow-up varying from 2 weeks to 3 months. Our results suggested that ALT could improve the preservation of CVCs and could be considered when their replacement is not possible as a result of vascular problems. However, only observational studies were included and RCTs are needed to confirm these findings and to increase the level of evidence.
由于一些血管异常情况或紧急状态，中心静脉导管（CVC）相关感染并非总能通过更换导管来解决。本项基于证据的全面综述旨在确定与中心静脉导管相关感染的标准治疗（SoC）相比，抗菌封管治疗（ALT）的疗效。我们在PubMed、Embase和谷歌学术上进行了系统检索，以查找随机对照试验（RCT）以及队列或病例对照观察性研究。纳入的合格研究为将诊断为中心静脉导管相关感染的受试者接受抗菌封管治疗（ALT）与标准治疗（SoC）进行比较的研究。在筛选过程结束时获得的609条记录中，本系统综述纳入了5篇涉及观察性研究的文章。在总共纳入276名个体的汇总分析中，微生物学治愈情况（比值比3.78；95%置信区间：2.03 - 7.03）显示抗菌封管治疗（ALT）与标准治疗（SoC）之间存在显著差异，随访时间从2周至3个月不等。我们的结果表明，抗菌封管治疗（ALT）可以提高中心静脉导管的保留率，并且在因血管问题无法更换导管时可以考虑使用。然而，本综述仅纳入了观察性研究，需要随机对照试验来证实这些发现并提高证据水平。
