Aksoy Firdevs, Karakoc Parlayan Hanife Nur, Oncu Kurutas Gulter, Yilmaz Gurdal
Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Türkiye.
Antibiotics (Basel). 2025 Apr 30;14(5):461. doi: 10.3390/antibiotics14050461.
This study aims to evaluate the use and efficacy of antibiotic-lock therapy (ALT) in the management of catheter-related bloodstream infections (CRBSIs), focusing on its impact on infection resolution, catheter retention, and clinical outcomes.
Patients aged ≥18 years diagnosed with CRBSIs who had long-term indwelling catheters and for whom catheter replacement posed clinical challenges were enrolled in the retrospective study from January 2019 to December 2024. Participants were divided into two groups based on treatment: Group 1 received intravenous (IV) antibiotics combined with antibiotic-lock therapy (ALT), while Group 2 received IV antibiotics alone. Patient demographics, pathogen distribution, administered antibiotic regimens, duration of treatment, laboratory parameters, clinical outcomes, and mortality rates were evaluated.
A total of 54 patients were included, of whom 42.6% were female, and the mean age was 66.3 ± 15.4 years. Group 1 comprised 50% of the study population. The median treatment duration was 14 days. The most common pathogen was , and 33.3% of CRBSIs were caused by Gram-negative bacteria (GNB). Group 1 demonstrated lower C-reactive protein levels at treatment 48/72 h of treatment ( = 0.013) and a reduced frequency of catheter revision ( < 0.0001) compared to Group 2. Overall, ALT achieved a success rate of 88.9%, with success rates of 86% for GNB infections and 90% for Gram-positive bacterial infections. Among patients receiving daily ALT, the success rate was 86%, while those receiving the therapy every three days had a success rate of 90%.
Antimicrobial lock therapy can be considered a treatment option for managing CRBSIs, particularly in cases where removal of the implantable catheter is not feasible, allowing for salvage.
本研究旨在评估抗生素封管疗法（ALT）在导管相关血流感染（CRBSIs）管理中的应用及疗效，重点关注其对感染消退、导管保留及临床结局的影响。
对2019年1月至2024年12月期间诊断为CRBSIs且有长期留置导管、更换导管存在临床挑战的≥18岁患者进行回顾性研究。参与者根据治疗方法分为两组：第1组接受静脉（IV）抗生素联合抗生素封管疗法（ALT），而第2组仅接受IV抗生素治疗。评估患者的人口统计学特征（译者注：此处原文demographics有多种释义，根据语境这里应指人口统计学特征）、病原体分布、使用的抗生素方案、治疗持续时间、实验室参数、临床结局及死亡率。
共纳入54例患者，其中42.6%为女性，平均年龄为66.3±15.4岁。第1组占研究人群的50%。中位治疗持续时间为14天。最常见的病原体是（译者注：此处原文缺失病原体信息），33.3%的CRBSIs由革兰氏阴性菌（GNB）引起。与第2组相比，第1组在治疗48/72小时时C反应蛋白水平较低（P = 0.013），导管修复频率降低（P < 0.0001）。总体而言，ALT的成功率为88.9%，GNB感染的成功率为86%，革兰氏阳性菌感染的成功率为90%。在接受每日ALT治疗的患者中，成功率为86%，而每三天接受一次该疗法的患者成功率为90%。
抗菌封管疗法可被视为管理CRBSIs的一种治疗选择，特别是在无法移除植入导管的情况下，能够实现挽救。
