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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)

Published on: February 9, 2011

Outcome of antibiotic lock technique for persistent central venous catheter-associated coagulase-negative

O Megged1, I Shalit, I Yaniv

  • 1Infectious Diseases Unit, Tel Aviv University, Tel Aviv, Israel.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|November 14, 2009
PubMed

Insights

The antibiotic lock technique (ALT) with vancomycin shows limited success in saving central venous catheters (CVCs) from Staphylococcus bloodstream infections in children. Long-term effectiveness was poor, particularly for implantable ports.

Area of Science:

  • Pediatric Infectious Diseases
  • Medical Device Infections
  • Antimicrobial Stewardship

Background:

  • Central venous catheter (CVC)-associated bloodstream infections (BSIs) pose significant risks in pediatric patients.
  • Coagulase-negative Staphylococcus (CONS) is a common pathogen in CVC-associated BSIs.
  • Salvaging infected CVCs is crucial to avoid complications and treatment interruptions.

Purpose of the Study:

  • To evaluate the long-term efficacy of the antibiotic lock technique (ALT) combined with systemic antibiotics for salvaging CVCs in pediatric patients with CONS BSIs.
  • To determine the success rates of CVC salvage at immediate and 3-month follow-up periods.

Main Methods:

  • Retrospective analysis of pediatric patients with CVC-associated CONS BSIs treated with systemic vancomycin and vancomycin ALT.
  • Assessment of CVC salvage rates as the primary outcome.
  • Comparison of salvage rates between different types of CVCs, including long-term transcutaneous CVCs (Hickman CVCs) and implantable ports.

Main Results:

  • Only 30% (7 out of 23) of CVCs were successfully salvaged.
  • Catheter removal was necessary in 8 cases due to persistent bacteremia.
  • Relapse of CONS bacteremia occurred in 6 patients within 30 days and 2 patients within 90 days.
  • Hickman CVCs demonstrated significantly higher salvage rates (75%) compared to implantable ports (18%, P = 0.05).

Conclusions:

  • Antibiotic lock technique (ALT) with vancomycin has limited long-term effectiveness for salvaging CVCs in pediatric CONS BSIs.
  • Implantable ports are associated with lower CVC salvage rates compared to Hickman CVCs.
  • Further prospective studies are warranted to comprehensively evaluate the long-term performance of ALT.

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