Kidney Week

Abstract: SA-PO0457

Alcohol Lock: A New Paradigm Shift in Managing Catheter-Related Blood Stream Infection in Patients on Hemodialysis

Session Information

• Dialysis: Vascular Access
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 803 Dialysis: Vascular Access

Authors

• Varma, Prem P., Venkateshwar Hospital Dwarka, New Delhi, DL, India

Prem P. Varma, MD, FASN

• Soni, Abhilasha, Venkateshwar Hospital Dwarka, New Delhi, DL, India

Abhilasha Soni, MD

• Dev, Kapil, Max Hospital Gurgaon, Gurugram, HR, India

Kapil Dev, MBA

Background

Majority of the hemodialysis get initiated with tunneled cuffed catheter (TCC). Catheter related blood stream infection (CRBSI) remains the fearful complication of TCC. Systemic antibiotics and antibiotic lock is the standard of care during CRBSI; but still catheter loss is a major concern. This report shows usefulness of using 70% alcohol lock (rather than antibiotic lock) in managing catheter salvage.

Methods

All patients with CRBSI were evaluated with routine blood counts, procalcitonin and blood cultures from (a) catheter hub and (b) periphery/dialysis circuit. Broad spectrum systemic antibiotics were started initially, which were tailored later, as per culture report. Study subjects were divided into two groups. Group A received 70% alcohol lock for 3 consecutive days and group B received antibiotic lock for 3 days, in addition to systemic antibiotics. 1.8ml of 70% alcohol or antibiotic was instilled in both catheter ports and was removed the next day, when fresh lock was placed. This process was repeated for 3 days. In case patient remained symptomatic after 3 days of treatment, catheter was removed Analysis was done by R version: R 4.4.1

Results

Over last five years, 541 TCC were placed. Eighty-seven patients developed definite CRBSI. Mean age of patients with CRBSI was 57+12.9 years with Male: Female ratio of 48:39. Mean total leucocyte count and Procal of these patients was 14.68+7.9/cmm and 46.8+47.9 ng/ml respectively. Twenty-one, 21/87 (24.1%) infections were due to gram positive organisms,1(1.1%) was due to candida and 64/87 (73.5%) were due to gram negative organisms. (table1). 22 patients were given antibiotic lock while 65 received alcohol lock. Eight, 8/65(12.3%), in Group A and15/22 (68.1%) in group B required catheter removal (p<0.0001). Over a mean follow up of 152 days there was no incidence of catheter leak or blockage in alcohol lock group.

Conclusion

Our study shows gram- negative organisms to be the lead offending organisms for CRBSI. Alcohol lock was associated with significantly better catheter salvage.

summary

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20251r604a6b