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Efficacy of antibiotic‐lock technique with teicoplanin in staphylococcus epidermidis catheter‐related sepsis during long‐term parenteral nutrition
Author(s) -
Guedon C,
Nouvellon M,
Lalaude O,
Lerebours E
Publication year - 2002
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607102026002109
Subject(s) - teicoplanin , parenteral nutrition , medicine , staphylococcus epidermidis , sepsis , antibiotics , lock (firearm) , catheter , intensive care medicine , microbiology and biotechnology , vancomycin , staphylococcus aureus , surgery , bacteria , biology , mechanical engineering , engineering , genetics
BACKGROUND: The antibiotic‐lock technique has been suggested to treat catheter‐related sepsis in parenteral nutrition and to avoid catheter removal. METHODS: To determine the incidence of catheter‐related sepsis, the bacteria involved, and the efficacy of the antibiotic‐lock technique with teicoplanin, all patients (n = 263) undergoing parenteral nutrition from January 1997 to December 1999 in one center, with patients at the hospital (n = 209) and at home (54) were retrospectively studied. The antibiotic‐lock technique with teicoplanin was systematically used in all suspected infections and maintained in staphylococcus epidermidis (SE) infections. RESULTS: A total of 21 of 263 patients had 34 infections (0.11/patient per year): 12 of 209 hospitalized and 9 of 54 home patients. A total of 10 of 34 infections were due to non‐SE, and the catheter was immediately removed. The other 24 of 34 infections were due to SE; in 5 of 24, the catheter was removed after 48 hours of the antibiotic‐lock technique because of persistent fever or thrombosis. A total of 5 of 12 patients had 2 or more infections on the same catheter. The antibiotic‐lock technique prevented short‐term catheter removal in these cases, but a second infection occurred within a median of 50 days. In 4 of 5 cases, a third infection occurred in a mean delay of 90 days so that the catheter was removed. In 3 of 5 patients, bacteria was analyzed with pulsed field gel electrophoresis, which showed that recurrent infections were due to the same strain in all cases. CONCLUSIONS: In this study, the incidence of catheter‐related sepsis was low and mostly related to SE. Our results do not support the use of the teicoplanin antibiotic‐lock technique in SE infections.