Effects of prophylactic use of taurolidine-citrate lock on the number of catheter-related infections in children under 2 years of age undergoing surgery.

Łyszkowska M, Kowalewski G, Szymczak M, Polnik D, Mikołajczyk A, Kaliciński P. J Hosp Infect. 2019 Oct;103(2):223-226. doi: 10.1016/j.jhin.2019.04.022.

The authors performed a randomised study in children (< 2 years of age) undergoing surgery. CVCs were mainly inserted for parenteral nutrition but also for the supply of drugs and blood products.

TauroLock™ was very successfully used for the prevention of catheter-related infections. We want to stress that the authors report no adverse events even in these very young children.

Methods:

86 children (97 catheters) undergoing surgery, CVCs were inserted for PN (mainly) or supply of drugs and blood products. CVCs were randomised to either standard aseptic procedures and locked with TauroLock™ (TauroLock™-group) or to standard aseptic procedures and locked with saline (saline-group). TauroLock™ dwell time was at least 2 hours (2 to 24 hours/day), depending on when CVCs were used next.

Results:

1. Catheter-related infections (CABSI)
   Significantly lower CABSI rate in the TauroLock™-group vs. saline-group (1.06 infections per 1000 catheter days vs. 14.3, p<0.05) .
   (Attention: in the publication CABSI is referred to as CRI)
2. CVC related costs:
   Immense cost savings were calculated when CVCs were blocked with TauroLock™. The average cost of treatment resulting from one CABSI was 3.304 €. With 16 CABSI in the saline-group and 1 in the TauroLock™-group the catheter related costs, including costs for lock solution, treatment of infections etc. were 52.864 € in the saline-group and 8.163 € in the TauroLock™-group.
3. Safety:
   No adverse events were reported.

Conclusions:

Use of TauroLock™ appears to be a safe and effective method of preventing CRI in very young children, and is associated with immense cost-savings.