Kidney Week

Abstract: TH-PO0960

Reduction in Hospital Central Line-Associated Blood Stream Infections (CLABSI) with Use of Heparin-Taurolidine Dialysis Catheter Locks

Session Information

• Vascular Access: Research and Cases
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 803 Dialysis: Vascular Access

Authors

• Veis, Judith H., MedStar Washington Hospital Center, Washington, District of Columbia, United States

Judith H. Veis, MD, FASN

• Khan, Noorelle, MedStar Washington Hospital Center, Washington, District of Columbia, United States

Noorelle Khan, MBBS

• Ponticello, Janette, MedStar Washington Hospital Center, Washington, District of Columbia, United States

Janette Ponticello, RN

Background

CLABSI remain a major complication of dialysis catheters in hospitalized patients with AKI and ESKD, contributing to increased morbidity and mortality. Medstar Washington Hospital Center is a large, urban hospital with 10,300 individual dialysis treatments yearly. Despite implementation of infection control measures: chlorhexidine impregnated dressings, daily chlorhexidine wipedowns, sterile line insertion, limiting use of dialysis lines; CLABSI related to dialysis catheters persisted. Based on 75% reduction in outpatients, a protocol for locking dialysis catheters with heparin-taurolidine (HT) (DefenCath^TM) was implemented in late 2024.

Methods

HT was instilled in lumens of temporary and tunneled dialysis catheters starting in November 2024, solely instilled by dialysis nurses and dwelled until subsequent dialysis. Allowed exclusions: heparin allergy or planned use of the catheter later that day. CLABSI were determined by National Healthcare Safety Network (NHSN) definition. Multidisciplinary event review was conducted for each CLABSI.

Results

An average of 4.0 CLABSI/quarter occurred in 24 months prior to implementation and 1.5 CLABSI/quarter in 12 months post. 4^th quarter 2024 excluded during ramp up of HT (62.5% reduction). No other changes in catheter management occurred over this time frame. Six infections occurred during 2025. Event reviews determined that HT was not used post dialysis in the week prior to bacteremia in 5/6 cases: planned use of isolated ultrafiltration (2), hemodynamic instability during dialysis with ICU transfer (2), in transition to comfort care (1). In the remaining case, AV graft may have been source, without culture confirmation.

Conclusion

Implementation of HT dialysis catheter lock solution reduced CLABSI in a large urban hospital setting in conjunction with ongoing infection prevention measures similar to the reduction seen in outpatients, with potential to improve outcomes in hospitalized dialysis-dependent patients.