Huo Zihe, Légeret Corinne, Holland-Cunz Stefan G, Gros Stephanie J
Department of Pediatric Surgery, University Children's Hospital Basel, Basel, Switzerland.
Department of Clinical Research, University of Basel, Basel, Switzerland.
Front Pediatr. 2025 Jun 18;13:1421992. doi: 10.3389/fped.2025.1421992. eCollection 2025.
Despite all precautions, central line-associated bloodstream infections (CLABSI) are inevitable, especially in children. Different treatment strategies exist for those situations. This study aims to compare the different treatment strategies.
In this study, central venous catheters (CVC, Broviac single lumen) were contaminated with . Different treatments (70% ethanol, ceftriaxone, TauroLock) were applied, and the effect was measured by isothermal microcalorimetry.
A rapid decrease in heat release corresponds to a rapid decrease in the number of living bacteria. Ceftriaxone had the quickest effect followed by ethanol in combination with ceftriaxone, ethanol, and TauroLock.
Antibiotics must be based on patient risk factors, the severity of infection, and local resistance pattern; therefore, it is difficult to publish general guidelines applying to all children. In this study, ceftriaxone demonstrated the most the highest efficacy on the bacteria. Taurolidine locks are recommended for preventing CLABSI, but no data are available in regards using it for treatment. In this setting, it was efficient, as was ethanol. However, the bacteria used in this study, have not been exposed to antibiotics before-this is most likely in contrast to patients, who have a central venous catheter.
Under conditions, systemic ceftriaxone is the most efficient and fastest treatment for an -infected CVC. Elimination of bacteria was also reached with 70% ethanol and TauroLock, but it needed more time.
尽管采取了所有预防措施,但中心静脉导管相关血流感染(CLABSI)仍不可避免,尤其是在儿童中。针对这些情况存在不同的治疗策略。本研究旨在比较不同的治疗策略。
在本研究中,中心静脉导管(CVC,Broviac单腔)被污染。应用了不同的治疗方法(70%乙醇、头孢曲松、TauroLock),并通过等温微量热法测量效果。
热释放的快速下降对应于活菌数量的快速减少。头孢曲松起效最快,其次是乙醇与头孢曲松联合使用、乙醇和TauroLock。
抗生素的使用必须基于患者的风险因素、感染的严重程度和局部耐药模式;因此,很难发布适用于所有儿童的通用指南。在本研究中,头孢曲松对细菌显示出最高的疗效。推荐使用牛磺罗定封管预防CLABSI,但尚无关于将其用于治疗的数据。在这种情况下,它和乙醇一样有效。然而,本研究中使用的细菌此前未接触过抗生素——这很可能与有中心静脉导管的患者情况相反。
在这种情况下,全身性头孢曲松是治疗感染的中心静脉导管最有效、最快的方法。70%乙醇和TauroLock也能消除细菌,但需要更多时间。