2153. Catheter Lock with Minocycline, EDTA and Ethanol for Salvaging of Central Venous Catheters in the Setting of Catheter Related Bloodstream Infections
Session: Poster Abstract Session: HAI: Device Related Infections
Saturday, October 7, 2017
Room: Poster Hall CD
Posters
  • Mino EDTA Ethanol_AMC-revised.pdf (563.8 kB)
  • Background: Long-term central venous catheters are essential in delivering care for critically ill and cancer patients. These catheters could lead to central line associated bloodstream infections (CLABSI). Removal and reinsertion of a new catheter may not always be feasible due to unavailability of vascular access in the setting of thrombocytopenia. A pilot open label study conducted at our institution showed promising results when Minocycline, EDTA, Ethanol (M-EDTA-EtOH) lock was used to salvage the catheter.

    Methods: Between October 2013 and August 2014, we prospectively enrolled 20 patients with catheter-related bloodstream infections (CRBSI) or CLABSI in three of our sister institutions in three countries including Brazil, Lebanon, and Japan. These patients received (M-EDTA-EtOH) lock therapy and were compared to 24 historical control patients who were matched based on organisms, underlying diseases and neutropenia status. The control patients had their CVCs removed and a new CVC inserted.

    Results: The two groups had comparable clinical characteristics. In the lock therapy group 95% of the patients had microbiological eradication within 96 hours after starting lock therapy vs. 83% of the patients in the control group (p= 0.36). In the lock group, the CVC was salvaged and retained for a median of 21 days (range 7-51) from the onset of bacteremia whereas the CVC was removed after a median of 2 days in the control group (range 0-8 days. P<0.0001).

    Conclusion: Our study suggests that M- EDTA-EtOH lock therapy seems to be an effective intervention to salvage long term CVCs in the setting of CLABSI/CRBSI in cancer and dialysis patients with limited vascular access.

    Ray Y. Hachem, MD, Infectious Diseases, Infection Control & Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, Souha Kanj, MD, FIDSA, American University of Beirut Medical Center, Beirut, Lebanon, Nelson Hamerschlak, MD, Hospital Israelita Albert Einstein, São Paulo, Brazil, Hala Saad, MD, American University of Beirut, Beirut, Lebanon, Fernanda Ferraz Assir, MD, Hospital Israelita Albert Einstein, San Pao, Brazil, Nobuyoshi Mori, MD, Infectious Diseases, St. Luke's International Hospital, Tokyo, Japan, Ying Jiang, MS, The University of Texas M. D. Anderson Cancer Center, Houston, TX, Fady Ghaly, MD, UT MD Anderson Cancer Center, Houston, TX, Anne-Marie Chaftari, MD, University of Texas MD Anderson Cancer Center, Houston, TX and Issam Raad, MD, Department of Infectious Diseases, University of Texas MD Anderson Cancer Center, Houston, TX

    Disclosures:

    R. Y. Hachem, None

    S. Kanj, None

    N. Hamerschlak, None

    H. Saad, None

    F. Ferraz Assir, None

    N. Mori, None

    Y. Jiang, None

    F. Ghaly, None

    A. M. Chaftari, None

    I. Raad, Merck: Grant Investigator , Research grant
    Allergan: Grant Investigator , Research grant
    Infective Technologies, LLC: Co-Inventor of the Nitroglycerin-Citrate-Ethanol catheter lock solution technology which is owned by the University of Texas MD Anderson Cancer Center (UTMDACC) and has been licensed by Novel Anti-Infective Technologies, LLC in which Dr. Raad is a s and Shareholder , Licensing agreement or royalty

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