Restricted accessCase reportFirst published online 2017-8
Management of Recurrent Catheter-Related Bloodstream Infections in an Adult Patient Receiving Home Parenteral Nutrition: Dramatic Effect of Ethanol Lock Therapy
We report the use of ethanol lock therapy to dramatically reduce the incidence of catheter-related bloodstream infections (CRBSIs) in a long-term adult home parenteral nutrition (HPN) patient. This case study demonstrates the efficacy of ethanol lock therapy in eliminating CRBSIs when other treatments have been unsuccessful. We suggest that ethanol lock therapy has an important role in decreasing CRBSI in HPN patients with recurrent CRBSIs.
HowardLAshleyC. Management of complications in patients receiving home parenteral nutrition. Gastroenterology. 2003;124(6):1651-1661.
2.
YousifAJamalMARaadI. Biofilm-based central line–associated bloodstream infections. Adv Exp Med Biol. 2015;830:157-179.
3.
MaiefskiMRuppMEHermsenED. Ethanol lock technique: review of the literature. Infect Control Hosp Epidemiol. 2009;30(11):1096-1108.
4.
TanMLauJGuglielmoBJ. Ethanol locks in the prevention and treatment of catheter-related bloodstream infections. Ann Pharmacother. 2014;48(5):607-615.
5.
SallesVJSaadSMatosD. Chronic wound infection: bacterial colonization in the dermal pericolostomic region. Wounds. 2008;20(4):107-109.
6.
OliveiraCNasrABrindleMWalesPW. Ethanol locks to prevent catheter-related bloodstream infections in parenteral nutrition: a meta-analysis. Pediatrics. 2012;129(2):318-329.
7.
OpillaMTKirbyDFEdmondMB. Use of ethanol lock therapy to reduce the incidence of catheter-related bloodstream infections in home parenteral nutrition patients. JPEN J Parenter Enteral Nutr. 2007;31(4):302-305.
8.
JohnBKKhanMASpeerhasR. Ethanol lock therapy in reducing catheter-related bloodstream infections in adult home parenteral nutrition patients: results of a retrospective study. JPEN J Parenter Enteral Nutr. 2012;36(5):603-610.
9.
Abu-El-HaijaMSchultzJRahhalRM. Effects of 70% ethanol locks on rates of central line infection, thrombosis, breakage, and replacement in pediatric intestinal failure. J Pediatr Gastroenterol Nutr. 2014;58(6):703-708.
10.
WeijmerMCDebets-OssenkoppYJVan De VondervoortFJter WeePM. Superior antimicrobial activity of trisodium citrate over heparin for catheter locking. Nephrol Dial Transplant. 2002;17(12):2189-2195.
11.
WeijmerMCvan den DorpelMAVan de VenPJ. Randomized, clinical trial comparison of trisodium citrate 30% and heparin as catheter-locking solution in hemodialysis patients. J Am Soc Nephrol. 2005;16(9):2769-2777.
12.
MermelLAAlangN. Adverse effects associated with ethanol catheter lock solutions: a systematic review. J Antimicrob Chemother. 2014;69(10):2611-2619.
