Association between antimicrobial locks for hemodialysis central venous catheters and antibiotic resistance

Wolley, Martin J., Taylor, Susan L., Hossain, Firoz, Abbas, Saib A. and Marshall, Mark R. (2012) Association between antimicrobial locks for hemodialysis central venous catheters and antibiotic resistance. Hemodialysis International, 16 S1: S2-S9. doi:10.1111/j.1542-4758.2012.00740.x


Author Wolley, Martin J.
Taylor, Susan L.
Hossain, Firoz
Abbas, Saib A.
Marshall, Mark R.
Title Association between antimicrobial locks for hemodialysis central venous catheters and antibiotic resistance
Journal name Hemodialysis International   Check publisher's open access policy
ISSN 1492-7535
1542-4758
Publication date 2012-10
Year available 2012
Sub-type Article (original research)
DOI 10.1111/j.1542-4758.2012.00740.x
Open Access Status Not yet assessed
Volume 16
Issue S1
Start page S2
End page S9
Total pages 8
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
Antimicrobial locks (AMLs) are effective in preventing catheter-associated bloodstream infections (CABSI) in hemodialysis (HD) patients, but may increase antibiotic resistance. In our center, gentamicin-heparin locks have been used for all HD central venous catheters since July 1, 2004. We previously reported a significant reduction in CABSI rates, but a short-term trend to increased gentamicin resistance among coagulase-negative staphylococci (CNS). We present a further 3-year follow-up study of bacterial resistance in our dialysis center. We examined the susceptibility of bacterial isolates from CABSI from July 1, 2006 to July 31, 2009, restricting analyses to CNS, gram-negative bacilli, and Staphylococcus aureus. We compared the frequency of gentamicin resistance in these isolates between four groups: CABSI in HD patients, non-CABSI in HD patients, peritonitis in peritoneal dialysis (PD) patients, and bloodstream infection in the non-end-stage kidney failure general population. For CNS isolates, the frequency of gentamicin resistance was similar between the CABSI and PD peritonitis groups, but higher in both groups than the general population. The pattern was similar for S. aureus although the differences were of borderline statistical significance. The frequency of gentamicin resistance among gram-negative bacilli isolates did not differ between groups. Gentamicin resistance was more common than expected in CNS and possibly S. aureus isolates from CABSI, although this resistance may be part of a generally higher frequency of antibiotic resistance in the dialysis population, rather than a direct result of AML use. AMLs remain a valuable clinical tool although surveillance is needed to ensure that benefits continue to outweigh risks. © 2012 The Authors. Hemodialysis International
Keyword Antibiotic lock
Antibiotic resistance
Bacterial susceptibility
Central venous catheter
Gentamicin
Hemodialysis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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