Fisher M, Golestaneh L, Allon M, Abreo K, Mokrzycki MH: Prevention of Bloodstream Infections in Patients Undergoing Hemodialysis. Clin J Am Soc Nephrol 15: 132–151, 2020; doi: 10.2215/CJN.06820619.
Due to an author error, dose units of heparin were listed incorrectly in a section in Table 3 in the three trials using taurolidine/citrate/heparin (refs 74–76). The correct dose of heparin was 500 units/ml in these preparations, not 5000 units/ml. The corrected portion of the table is below.
Table 3.
Study | N | Methods | Standard Definition of Bloodstream Infection Used | Definition of Bloodstream Infection | Antimicrobial Locking Solution | Control | Outcome | Rate/1000 Catheter-Days | P Value | Concerns |
---|---|---|---|---|---|---|---|---|---|---|
Solomon et al. (74) | 174 | Prospective, cohort study compared with historical controls | No | A single positive blood culture | Taurolidine 1.35%/citrate 4%/heparin 500 U/ml | a) Heparin 5000 U/ml | a1) Bloodstream infection | a1) 1.33 versus 3.25 | a1) 0.001 | Cost |
b) Taurolidine 1.35%/Citrate 4% | ||||||||||
a2) First use of thrombolytic | a2) RR 1.4 (0.5–3.9) | a2) 0.5 | ||||||||
b1) Blood stream infection | b1) 1.33 versus 1.22 | b1) 0.001 | ||||||||
b2) First use of thrombolytic | b2) RR0.2 (0.06 to 0.5) | b2) 0.001 | ||||||||
Winnicki et al. (75) | 106 | Multicenter, randomized, controlled trial | No | A positive bacterial blood culture drawn from the dialysis catheter in a symptomatic patient with fever or chills associated with dialysis and no apparent other source of infection | Taurolidine 1.35%/citrate 4%/heparin 500 U/ml twice a wk with taurolidine 1.35%/citrate 4%/urokinase 25,000 U once a wk | Citrate 4% | a) Bloodstream infection | a) 0.67 versus 2.7 | 0.003 | Cost |
b) Catheter dysfunction | b) 18.7 versus 44.3 | 0.001 | ||||||||
Al-Ali et al. (76) | 164 | Multicenter, single- blinded, randomized, controlled trial | No | Same organism obtained from blood aspirated through the catheter hub and from blood sample obtained from peripheral vein with no other identifiable cause of infection | Taurolidine 1.35%/citrate 4%/heparin 500 U/ml twice a wk with taurolidine 1.35%/citrate 4%/urokinase 25,000 U once a wk | Taurolidine 1.35%/citrate 4%/heparin 500 U/ml three times a wk | a) Catheter removal for bloodstream infection | a) 0 versus 3 | 0.08 | Cost |
b) Catheter removal for dysfunction | b) 1 versus 4 | 0.17 | ||||||||
c) Need for tissue plasminogen activator use | c) 5 versus 12 | 0.61 |
Footnotes
Published online ahead of print. Publication date available at www.cjasn.org.
See original article, “Prevention of Bloodstream Infections in Patients Undergoing Hemodialysis,” in Vol. 15, Iss. 1, on pages 132–151.