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Significant Reduction in Central Venous Catheterrelated Bloodstream Infections in Children on HPN After Starting Treatment With Taurolidine Line Lock

Chu, Hui-Ping; Brind, Joanne; Tomar, Rajeev; Hill, Susan

Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e31825bb0ae
Hepatology and Nutrition
Abstract

Objective: The aim of this study was to review the incidence and type of central venous catheter–related bloodstream infection in children on treatment with home parenteral nutrition (PN) before and after the introduction of taurolidine. Taurolidine is a catheter lock solution that prevents biofilm formation and has broad-spectrum bactericidal and antifungal action. Its use in pediatric patients on PN has only been reported in case studies.

Methods: A total of 19 children were reviewed, with the diagnoses of enteropathy (8 cases), short bowel syndrome (7 cases), and gastrointestinal dysmotility (4 cases). Incidence and type of sepsis were reviewed for 8 to 12 months pre- (when heparin was used) and 2 to 33 months postintroduction of the taurolidine catheter lock.

Results: There were 8.6 episodes of catheter-related bloodstream infections per 1000 catheter days with heparin and 1.1 episodes per 1000 catheter days with taurolidine (P = 0.002). A total of 14 of the 19 patients (74%) had no infections for up to 33 months after changing to taurolidine. No reports of multiresistant organisms or adverse effects with taurolidine were found.

Conclusions: Taurolidine line lock was associated with a decreased incidence of catheter-related bloodstream infections. This finding supports its use in patients with a history of septicemia on treatment with cyclical PN.

Author Information

Gastroenterology Department, Great Ormond Street Hospital, London, UK.

Address correspondence and reprint requests to Dr Susan Hill, Department of Gastroenterology, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK (e-mail: susan.hill@gosh.nhs.uk).

Received 2 February, 2012

Accepted 23 April, 2012

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN