Abstract:Objective This research was designed to explore the effect of antibiotic lock technique (ALT) in preventing implantable venous access port (IVAP)-related infection in infants with malignant tumors. MethodsSixty infants with neurological malignant tumors were underwent implantation of IVAP by the same surgical team in our hospital. They were randomly divided into two groups. Prophylactic cefuroxime mixed with heparin saline was used as the seal liquid in 30 infants after the implantation, and the same volume of heparin saline was applied in the other 30 infants. All the patients were followed to observe whether there was IVAP-related infection within one month. The differences between two groups were compared and the risk factors for IVAP were investigated. ResultsThe general characteristics had no significant difference between two groups. Only one infant got infection in the ALT group (3.33%), while four infants developed infection in the control group (13.33%). Although the difference between two groups was not statistically significant (P=0.353). No significant independent risk factor for IVAP was revealed by the present study. ConclusionThe application of ALT in the IVAP implantation might be an effective method to decrease the infection rate in infants with malignant tumors to a large extent, but it still needs a large sample of research to confirm the clinical effect.
于海蛟,朱昱冰,李稳霞,赵爱民,丁磊,高宏,马玲. 应用抗生素锁技术预防婴幼儿输液港感染的随机对照研究[J]. 肿瘤代谢与营养电子杂志, 2020, 7(4): 428-432.
Yu Haijiao, Zhu Yubing, Li Wenxia, Zhao Aimin, Ding Lei, Gao Hong, Ma Ling. Randomized controlled trial of application of antibiotic lock technique in preventing implantable venous access port-related infection in infants. Electron J Metab Nutr Cancer, 2020, 7(4): 428-432.
1.NIEDERHUBER J E, ENSMINGER W, GYVES J W, et al. Totally implanted venous and arterial access system to replace external catheters in cancer treatment[J]. Surgery, 1982, 92(4): 706-712.
2.LEE P H, LIU C L, JENG K S, et al. Complications of totally implantable central venous access port[J]. Formosan Journal of Surgery, 2003, 36(1):18-24.
3.WOLOSKER N, YAZBEK G, NISHINARI K, et al. Totally implantable venous catheters for chemotherapy: experience in 500 patients[J]. So Paulo Med J, 2004, 122: 147-151.
4.WANG T Y, LEE K D, CHEN P T, et al. Incidence and risk factors for central venous access port related infection in Chinese cancer patients[J]. J Formos Med Assoc, 2015, 114(11): 1055-1060.
5.TOUR A, VANHENMS P, LOMBARD-BOHAS C, et al. Totally implantable central venous access port infections in patients with digestive cancer: incidence and risk factors[J]. Am J Infect Control, 2012, 40(10): 935-939.
6.YAZICI N, AKYUZ C, YALCIN B, et al. Infectious complications and conservative treatment of totally implantable venous access devices in children with cancer[J]. Turk J Pediatr, 2013, 55(2): 164-171.
7.FRATINO G, MOLINARI A C, PARODI S, et al. Central venous catheter-related complications in children with oncological/hematological diseases: an observational study of 418 devices[J]. Ann Oncol, 2005, 16(4):648-654.
8.YILDIZELI B, LAIN T, BATIREL HF, et al. Complications and management of long-term central venous access catheters and ports[J]. J Vasc Access, 2004, 5(4):174-178.
9.NIYYAR V D, LOK C E. Pros and cons of catheter lock solutions[J]. Curr Opin Nephrol Hypertens, 2013, 22(6):669-674.
10.FERNNDEZ-HIDALGO, NURIA, ALMIRANTE B. Antibiotic-lock therapy: a clinical viewpoint[J]. Expert Rev Anti Infect Ther, 2014, 12(1):117.
11.MERMEL LA, ALLON M, BOUZA E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 updated by the Infectious Disease Society of America[J]. Clin Infect Dis, 2009, 49(1): 1-45.
12.LEBEAUX D, FERNNDEZ-HIDALGO, NURIA, CHAUHAN A, et al. Management of infections related to totally implantable venous-access ports: challenges and perspectives[J]. Lancet Infect Dis, 2014, 14(2):146-159.
13.中心静脉通路上海协作组. 完全植入式输液港上海专家共识[J]. 介入放射学杂志, 2015, 24(12): 1029-1033.
14.樊跃平, 张田, 曲芊诺, 等. 中国恶性肿瘤营养治疗通路专家共识解读—经外周静脉置管部分[J]. 肿瘤代谢与营养电子杂志, 2019, 6(3): 301-304.
15.胡燕, 白继庚, 胡先明等. 我国抗生素滥用现状、原因及对策探讨[J]. 中国社会医学杂志. 2013, 30(2): 128-130.
16.KARANLIK H, KURUL S, SAIP P, et al. The role of antibiotic prophylaxis in totally implantable venous access device placement: results of a single-center prospective randomized trial[J]. Am J Surg, 2011, 202(1): 10-15.
17.JOHNSON E, BABB J, SRIDHAR D. Routine antibiotic prophylaxis for totally implantable venous access device placement: meta-analysis of 2, 154 patients[J]. J Vasc Interv Radiol, 2016, 27(3):339-343.
18.DONLAN R M. Biofilms: microbial life on surfaces[J]. Emer Infect Dis, 2002, 8: 881-190.
19.DONLAN R M. Biofilm elimination on intravascular catheters: important considerations for the infectious disease practitioner[J]. Clin Infect Dis, 2011, 52(8):1038-1045.
20.VESCIA S, BAUMGRTNER A K, JACOBS V R, et al. Management of venous port systems in oncology: a review of current evidence[J].Ann Oncol, 2008, 19(1): 9-15.
21.VIALE P, PAGANI L, PETROSILLO N, et al. Antibiotic lock-technique for the treatment of catheter-related bloodstream infections[J]. J Chemother, 2003, 15(2): 152-156.
22.孔梅婧, 沈国妹, 王颖雯. 113例植入式静脉输液港在肿瘤患儿中的应用及并发症处理[J]. 护理研究, 2013, 8(27): 2646-2647.
23.YAHAV D, ROZEN-ZVI B, GAFTER-GVILI A, et al. Antimicrobial lock solutions for the prevention of infections associates with intravascular catheters in patients undergoing hemodialysis: systematic review and meta-analysis of randomized, controlled trials[J]. Clin Infect Dis, 2008, 47: 83-93.
24.SAFDAR N, MAKI DG. Use of vancomycin-containing lock or flush solutions for prevention of bloodstream infection associated with central venous access device: a meta-analysis of prospective, randomized trials[J]. Clin Infect Dis, 2006, 43: 474-484.
25.王立翠, 执湖仙, 刘莉娟. 长效抗菌材料和纳米银抗菌凝胶在植入静脉输液港并发囊袋切口感染中的应用[J]. 中外女性健康研究, 2018, 4(8): 141-142.