Abstract: SA-PO1097
Use of Gentamicin-Citrate Lock Reduced Catheter-Related Bloodstream Infection Rates in Hemodialysis Patients: Results of a Natural Experiment
Session Information
- Vascular Access - II
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 704 Dialysis: Vascular Access
Authors
- Hussein, Wael F., Satellite Healthcare, San Jose, California, United States
- Yang, Fang, Satellite Healthcare, San Jose, California, United States
- Sun, Sumi J., Satellite Healthcare, San Jose, California, United States
- Abra, Graham E., Satellite Healthcare, San Jose, California, United States
- Schiller, Brigitte, Satellite Healthcare, San Jose, California, United States
Background
Use of central venous catheters (CVC) is a major risk factor for infections, a leading cause of morbidity and mortality in hemodialysis (HD) patients. Use of gentamicin 320 μg/mL in 4% sodium citrate lock (GCL) was previously shown to reduce the rate of CVC-related bloodstream infection (BSI). We report on the change of CVC-related BSI rates in four centers experiencing high BSI rates while using heparin catheter lock (period 1 [P1]) after switching to GCL (period 2 [P2]).
Methods
Retrospective observational study. Patient characteristics at time of switch to GCL were obtained from the provider’s EHR. CVC patient-months and reported events of CVC-related BSI were obtained from the NHSN database. The rate ratio for pooled rates for P2:P1 was calculated and tested for significance.
Results
There were 684 and 896 CVC patient-months in P1 and P2 respectively. Mean patient age was 64 ± 14 years, and 48% were female. Monthly CVC-related BSI rates are shown in Figure 1. Pooled CVC-related BSI rates were 2.8 and 0.6 per 100 patient-months for P1 and P2 respectively, representing an 80% reduction in the rate of BSI (rate ratio 0.20, 95% Confidence interval 0.08 – 0.54, p = 0.0004).
Conclusion
These results are consistent with results from a previous trial, but in real-practice setting. Use of the gentamicin-citrate lock significantly reduces CVC-related BSI.
Figure 1