Can vancomycin lock therapy extend the retention time of infected long‐term catheters?

We assessed the success rate of vancomycin catheter lock therapy (VLT) in combination with systemic antimicrobials in patients with staphylococcal catheter‐related bloodstream infection (C‐RBSI). Over a 6‐year period, we retrospectively collected clinical and microbiological data from patients with...

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Published in:APMIS : acta pathologica, microbiologica et immunologica Scandinavica microbiologica et immunologica Scandinavica, 2020-06, Vol.128 (6), p.433-439
Main Authors: Alonso, Beatriz, Fernández‐Cruz, Ana, Díaz, Marta, Sánchez‐Carrillo, Carlos, Martín‐Rabadán, Pablo, Bouza, Emilio, Muñoz, Patricia, Guembe, María
Format: Article
Language:English
Subjects:
Antimicrobial agents
Catheters
Catheter‐related bloodstream infection
Coagulase
CoNS
Criteria
Medical instruments
Nutrition
Parenteral nutrition
Retention
Retention time
Staphylococcus aureus
Statistical analysis
Success
success rate
Therapy
Vancomycin
vancomycin catheter lock therapy
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Summary:We assessed the success rate of vancomycin catheter lock therapy (VLT) in combination with systemic antimicrobials in patients with staphylococcal catheter‐related bloodstream infection (C‐RBSI). Over a 6‐year period, we retrospectively collected clinical and microbiological data from patients with long‐term central venous catheters and staphylococcal C‐RBSI who were treated with systemic antimicrobials and VLT. We then assessed the success rate of VLT based on two criteria: 1) catheter retention time> 3 months and 2) catheter in place until end of use. We found 217 staphylococcal C‐RBSI episodes, 115 (53.0%) of which were managed with conservative therapy. Of these, 76 (66.1%) were treated with VLT (85.5% coagulase‐negative staphylococci and 14.5% Staphylococcus aureus). The success rate of VLT was 42.1% with criterion 1 and 71.1% with criterion 2. We did not find statistically significant differences between success and failure in the majority of the clinical data recorded. We only found differences for crude mortality in criterion 1 and for parenteral nutrition in criterion 2. The success of catheter retention using VLT was moderate, reaching slightly more than 70% when the catheter was kept in place until the end of use.
ISSN:0903-4641
1600-0463
DOI:10.1111/apm.13033