Taurolock (Taurolouidine Citrate) Versus Vancomycin In Prevention Of Hemodialysis Cathter Related Blood Stream Infection

Research Article
Ayman Aly Seddik, Abdelrahman Khedr, and Tamer Elsaid
DOI: 
xxx-xxxxx-xxxx
Subject: 
science
KeyWords: 
Taurolouidine, vancomycin , cathter lock solution
Abstract: 

Introduction: Central Line associated Blood Stream Infection CLABSI as defined a single blood culture for organisms not commonly present on the skin and two or more blood cultures for organisms commonly present on the skin in a patient who has a central line at the time of infection or within the 48- hour period before development of infection. CRBSI constitutes a major clinical and economic problem and Antimicrobial lock therapy is commonly used for CVC management in a prophylactic modality in patients with protracted central venous access for hemodialysis (HD), chemotherapy, or total parenteral nutrition Patients And Methods: a prospective, open-label randomized trial conducted at a single medical center At Hemodialysis unit Ain Shams university hospital . 41 Patients were randomly assigned to receive interdialytic catheter locking with either vancomycin/ heparin or taurolidine/citrate; TauroLock at the end of each dialysis session and continuously since catheter insertion. Results: no significant difference in study groups regarding age distribution with age 59.39 ± 15.69 and 57.83 ± 16.12 for vancomycin and Taurolock groups respectitively . majority of patients have permenant Hemodialysis cathters and only 5 patients had temporary internal jugular cathter ( 1 in vancomycin group and 4 in taurollock group ), total dialysis days in vancomycin group (202.83 ± 97.88 days ) higher than in Taurolock group (189.17 ± 99.42 days )but without significant difference p value (0.663) . And that there was infection positive dialysis days was higher in Taurolock group (22.09 ± 28.47day) than the vancomycin group (18.47 ± 22.75 days ) without statistical significance p value (0.622) , episodes of infection per 1000 cathter dialysis days was slightly higher in vancomycin group (0.558±0.466 infection episode /1000 cathter dialysis days ) than Taurolock group (0.528±0.380 infection episode /1000 cathter dialysis days ) however statistically insignificant . Discussion: Our results regarding the reduction of cathter related blood stream infection by using vancomycin based cathter lock solution come in accordance with the results of recent metaanalysis in january 2015 conducted by Macarena et al (21) , The key messages of his analysuis are consistent with the findings of the individual systematic reviews identified recommends its use only in patients with multiple central venous catheter related blood stream infections . Conclusion: Up to our knowledge this is the 1st trial comparing the effectiveness of Taurolock versus vancomycin in prevention of cathter related blood stream infection and interpretation of the results showed that Taurolock have comparable efficacy on reducing the rate of infection and maintain cathter survival.