Role of antibiotic lock in the prevention of catheter induced infection in patients undergoing hemodialysis.

Abstract

Objective: To determine the role of antibiotic lock in the prevention of catheter related infection in patients undergoing hemodialysis at a tertiary care hospital. Study Design: Descriptive Case Series. Setting: Department of Nephrology, Nishtar Hospital in Multan. Period: 1^st March 2021 to 31^st May 2021. Methods: Following approval from the ethics review committee, 136 patients who presented to the Department of Nephrology at Nishtar Hospital in Multan and met the inclusion criteria were selected after informed consent. After each session of dialysis, catheter lock solution (CLS) containing 1.35% taurolidine and 4% sodium citrate was fed into both catheter lumens. This solution was then withdrawn prior to the beginning of the second session, and these patients were observed for a period of ninety days. Results: Of 136 patients, 66.9 % (n=91) were male, their mean age was 53.04 ± 9.60 years. Of these 136 patients, 38.2 % (n = 52) were from poor social background. Diabetes was noted in 25.7 % (n = 35) and hypertension in 47.8 % (n = 65). Obesity was noted in 14.0 % (n = 19). Infection free survival of the catheter was noted in 89.7 % (n = 122) of our participants. Infection prevention was significantly higher in ≤ 50-years old (p-value 0.023), from urban population (p-value 0.001), poor socioeconomic status (0.002) and non-diabetic patients (0.048). Conclusion: Non-Diabetics, age ≤50-years, urban residence, and poor socioeconomic standing were significantly related with prevention of catheter infection using antibiotic lock. It is recommended to use taurolidine based lock solutions in dialysis facilities.