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Prevention of Coagulase-Negative Staphylococcal Central Venous Catheter–Related Infection Using Urokinase Rinses: A Randomized Double-Blind Controlled Trial in Patients With Hematologic Malignancies
Prevention of CNS CVCRI using urokinase rinses
【摘要】
Purpose
Fibrin deposition at the intraluminal surface of the indwelling part of the central venous catheter
(CVC) surface increases the risk of CVC-related coagulase-negative staphylococci (CoNS) infection.
Therefore, repetitive enzymatic dissolution of fibrin by urokinase might reduce the risk of
CVC-related infection. We undertook this study to investigate whether three times weekly
urokinase rinsing of CVC reduces the incidence or severity of CVC-related infections by CoNS in
patients undergoing intensive cytotoxic treatment for hematologic malignancies.
Patients and Methods
In a double-blind setting, all consecutive patients with a CVC were randomly allocated to receive
either urokinase rinses (5 mL of 5,000 U/mL) or placebo (saline), both three times weekly.
Results
The percentage of patients with at least one positive culture with CoNS was lower in patients
receiving urokinase compared with patients receiving placebo (26% v 42%, respectively; relative
risk [RR] 0.61; 95% CI, 0.39 to 0.94). Major CVC-related CoNS infection occurred less frequently
in patients receiving urokinase versus placebo (1.2% v 14.1%, respectively; RR 0.09; 95% CI,
0.01 to 0.50). Secondary complications, including CVC-related thrombosis, were observed less
frequently in the urokinase group compared with the placebo group (1.3% v 9.0%, respectively;
RR 0.14; 95% CI, 0.02 to 0.82). No severe bleeding complications attributable to urokinase
were observed.
Conclusion
Three times weekly urokinase rinsing reduces the incidence of CVC-related CoNS infection in
patients treated with intensive cytotoxic therapy for hematologic malignancies, with acceptable
safety.
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发表于 2011-10-29 00:40
发表于 2011-10-29 01:07
