Alfieri Aniello, Di Franco Sveva, Passavanti Maria Beatrice, Pace Maria Caterina, Simeon Vittorio, Chiodini Paolo, Leone Sebastiano, Fiore Marco
Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Medical Statistics Unit, Department of Public, Clinical and Preventive Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy.
Microorganisms. 2025 Feb 13;13(2):406. doi: 10.3390/microorganisms13020406.
Antimicrobial lock therapy (ALT) prevents microbial colonization in central vein catheters and treats existing catheter-related bloodstream infections (CRBSIs); the ALT assessment involves several key considerations. First, identifying which patients are suitable candidates is crucial. Additionally, understanding the clinical contexts in which is utilised provides insight into its applications. Examining when ALT has been employed and analyzing trends in its use over time can highlight its evolving role in patient care. Equally important is understanding how ALT is administered, including the specific agents used. Lastly, determining whether there is sufficient existing literature is essential to evaluate the feasibility of conducting future systematic reviews. This study is a scoping review adhered to the PRISMA-ScR guidelines and followed a five-stage methodological framework. Of the 1024 studies identified, 336 were included in the analysis. Findings highlight the widespread use of ethanol and taurolidine for CRBSIs prevention and the concurrent use of ALT with systemic antimicrobials to treat CRBSIs without catheter removal. ALT improves clinical outcomes, including post-infection survival and catheter retention. From our analysis, we have concluded that both an umbrella review of systematic reviews and a network meta-analysis comparing lock solutions can provide clearer guidance for clinical practice.
抗菌封管疗法(ALT)可预防中心静脉导管中的微生物定植,并治疗现有的导管相关血流感染(CRBSIs);ALT评估涉及几个关键因素。首先,确定哪些患者是合适的候选者至关重要。此外,了解其使用的临床背景有助于深入了解其应用情况。检查ALT何时被采用以及分析其随时间的使用趋势可以突出其在患者护理中不断演变的作用。同样重要的是了解ALT的给药方式,包括所使用的具体药物。最后,确定是否有足够的现有文献对于评估进行未来系统评价的可行性至关重要。本研究是一项遵循PRISMA-ScR指南并采用五阶段方法框架的范围综述。在确定的1024项研究中,336项被纳入分析。研究结果突出了乙醇和牛磺罗定在预防CRBSIs方面的广泛应用,以及ALT与全身抗菌药物同时使用以治疗CRBSIs且不拔除导管的情况。ALT可改善临床结局,包括感染后生存率和导管保留率。通过我们的分析,我们得出结论,对系统评价进行汇总分析以及比较封管溶液的网状荟萃分析都可以为临床实践提供更清晰的指导。