ArticleClinical journal of the American Society of Nephrology : CJASN2010
Emergence of gentamicin-resistant bacteremia in hemodialysis patients receiving gentamicin lock catheter prophylaxis.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 154 citations in OpenAlex.
- Systematic review and meta-analysis on management of hemodialysis catheter-related bacteremia.Journal of the American Society of Nephrology : JASN · 2014Pooled it
- Pooled it
- Trial
- Trial
- Minocycline-EDTA lock solution prevents catheter-related bacteremia in hemodialysis.Journal of the American Society of Nephrology : JASN · 2011Trial
- Intermittent antibiotic exposure of Escherichia coli biofilms drives resistance in catheter-associated infection models.NPJ biofilms and microbiomes · 2026Article
- Impact of sodium bicarbonate locking solution on catheter-related blood stream infection in hemodialysis patients: comparative effectiveness of three locks.Journal of nephrology · 2025Article
- Use of 4% tetrasodium EDTA (KiteLock™) to prevent central venous catheter-related bloodstream infections in pediatric hemodialysis patients.Pediatric nephrology (Berlin, Germany) · 2025Article
- Antibiotic lock therapy for the treatment of peripherally inserted central venous catheter-related bloodstream infection in patients with hematological malignancies: a single center retrospective study.Annals of hematology · 2025Article
- Review
- Ethanol Lock for Prevention of CVC-Related Bloodstream Infection in Pediatric Patients: A Systematic Review and Meta-Analysis.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2023Article
- Reevaluation of lock solutions for Central venous catheters in hemodialysis: a narrative review.Renal failure · 2022Review
- Article
- Antimicrobial activity of hemodialysis catheter lock solutions in relation to other compounds with antiseptic properties.PloS one · 2021Article
- REDUcing the burden of dialysis Catheter ComplicaTIOns: a National approach (REDUCCTION) - design and baseline results.Kidney360 · 2020Article
- Review
- Chlorhexidine locking device for central line infection prevention in ICU patients: protocol for an open-label pilot and feasibility randomized controlled trial.Pilot and feasibility studies · 2020Article
- Trisodium citrate 4% versus heparin as a catheter lock for non-tunneled hemodialysis catheters in critically ill patients: a multicenter, randomized clinical trial.Annals of intensive care · 2019Article
- Article
- Comparison of the effect of antibiotic-lock and ethanol-lock methods on infection rate in children with hemodialysis catheter.American journal of clinical and experimental urology · 2019Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesAntibiotic locks in catheter-dependent chronic hemodialysis patients reduce the rate of catheter-related blood stream infections (CRIs), but there are no data regarding the long-term consequences of this practice. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Over a 4-year period, from October 1, 2002, to September 30, 2006, we initiated a gentamicin and heparin lock (GHL) protocol in 1410 chronic hemodialysis patients receiving dialysis through a tunneled catheter in eight outpatient units.
resultsWithin the first year of the GHL protocol, our CRI rate decreased from 17 to 0.83 events per 1000 catheter-days. Beginning 6 months after initiation of the GHL protocol, febrile episodes occurred in 13 patients with coagulase-negative Staphylococcus bacteremia resistant to gentamicin. Over the 4 years of GHL use, an additional 10 patients developed 11 episodes of gentamicin-resistant CRI (including 7 with Enterococcus faecalis), in which there were 4 deaths, 2 cases of septic shock requiring intensive care unit admission, and 4 cases of endocarditis. Because of these events, the GHL protocol was discontinued at the end of 2006.
conclusionsAlthough the use of GHL effectively lowered the CRI rate in our dialysis population, gentamicin-resistant CRIs emerged within 6 months. Gentamicin-resistant infections are a serious complication of the long-term use of GHLs. Alternative nonantibiotic catheter locks may be preferable to decrease the incidence of CRIs without inducing resistant pathogens.
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