Antimicrobial Locks in Patients Receiving Home Parenteral Nutrition
1
Department of Medicine, Division of Gastroenterology, Centre Hospitalier de l’Universite de Montreal (CHUM), Centre de Recherche du Centre Hospitalier de l’Universite de Montreal (CRCHUM), 1051 Rue Sanguinet, Montreal, Québec H2X 3E4, Canada
2
Intestinal Failure Unit, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
3
Center for Intestinal Failure, Department of Gastroenterology and Nutritional Support, Reference Centre of Rare Disease MarDI, Hopital Beaujon, University of Paris Inserm UMR 1149, 92110 Clichy, France
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(2), 439; https://doi.org/10.3390/nu12020439
Received: 8 January 2020 / Revised: 2 February 2020 / Accepted: 3 February 2020 / Published: 10 February 2020
(This article belongs to the Special Issue Advances of Parenteral Nutrition)
Catheter-related bloodstream infection (CRBSI) is one of the most common and potentially fatal complications in patients receiving home parenteral nutrition (HPN). In order to prevent permanent venous access loss, catheter locking with an antimicrobial solution has received significant interest and is often a favored approach as part of the treatment of CRBSI, but mainly for its prevention. Several agents have been used for treating and preventing CRBSI, for instance antibiotics, antiseptics (ethanol, taurolidine) and, historically, anticoagulants such as heparin. Nonetheless, current guidelines do not provide clear guidance on the use of catheter locks. Therefore, this review aims to provide a better understanding of the current use of antimicrobial locking in patients on HPN as well as reviewing the available data on novel compounds. Despite the fact that our current knowledge on catheter locking is still hampered by several gaps, taurolidine and ethanol solutions seem promising for prevention and potentially, but not proven, treatment of CRBSI. Additional studies are warranted to further characterize the efficacy and safety of these agents.
Keywords:
catheter-related bloodstream infection; antimicrobial lock therapy; home parenteral nutrition; biofilm; catheter salvage
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
MDPI and ACS Style
Daoud, D.C.; Wanten, G.; Joly, F. Antimicrobial Locks in Patients Receiving Home Parenteral Nutrition. Nutrients 2020, 12, 439.
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