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Comparative Study
. 2014 Nov 7;9(11):e111216.
doi: 10.1371/journal.pone.0111216. eCollection 2014.

Taurolidine lock is superior to heparin lock in the prevention of catheter related bloodstream infections and occlusions

Evelyn D Olthof  1 , Michelle W Versleijen  2 , Getty Huisman-de Waal  3 , Ton Feuth  4 , Wietske Kievit  4 , Geert J A Wanten  1
Affiliations
Comparative Study

Taurolidine lock is superior to heparin lock in the prevention of catheter related bloodstream infections and occlusions

Evelyn D Olthof et al. PLoS One. .

Abstract

Background and aims: Patients on home parenteral nutrition (HPN) are at risk for catheter-related complications; mainly infections and occlusions. We have previously shown in HPN patients presenting with catheter sepsis that catheter locking with taurolidine dramatically reduced re-infections when compared with heparin. Our HPN population therefore switched from heparin to taurolidine in 2008. The aim of the present study was to compare long-term effects of this catheter lock strategy on the occurrence of catheter-related bloodstream infections and occlusions in HPN patients.

Methods: Data of catheter-related complications were retrospectively collected from 212 patients who received HPN between January 2000 and November 2011, comprising 545 and 200 catheters during catheter lock therapy with heparin and taurolidine, respectively. We evaluated catheter-related bloodstream infection and occlusion incidence rates using Poisson-normal regression analysis. Incidence rate ratios were calculated by dividing incidence rates of heparin by those of taurolidine, adjusting for underlying disease, use of anticoagulants or immune suppressives, frequency of HPN/fluid administration, composition of infusion fluids, and duration of HPN/fluid use before catheter creation.

Results: Bloodstream infection incidence rates were 1.1/year for heparin and 0.2/year for taurolidine locked catheters. Occlusion incidence rates were 0.2/year for heparin and 0.1/year for taurolidine locked catheters. Adjusted incidence ratios of heparin compared to taurolidine were 5.9 (95% confidence interval, 3.9-8.7) for bloodstream infections and 1.9 (95% confidence interval, 1.1-3.1) for occlusions.

Conclusions: Given that no other procedural changes than the catheter lock strategy were implemented during the observation period, these data strongly suggest that taurolidine decreases catheter-related bloodstream infections and occlusions in HPN patients compared with heparin.

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Conflict of interest statement

Competing Interests: The authors of this manuscript have the following competing interests: GJAW has performed research and given presentations that were supported by fees from Geistlich and grants from Geistlich Pharma, Fresenius Kabi and Baxter. EDO, MWJV, GJHW, TF and WK declare no conflict of interest. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Flowchart of numbers of patients and catheters.
Figure 2
Figure 2. Hospital admissions in period 2006 until 2011.
Catheters were locked with heparin (2006–2007) and taurolidine (2009–2011). In 2008 admissions of both lock strategies were included. Data are presented as the days that the patients were admitted to our ward divided by the total number of catheter days.
See this image and copyright information in PMC

References

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