单剂量预防性万古霉素在半永久性导管插入术前预防导管相关感染的效果;随机对照试验,II期

IF 0.2 Q4 UROLOGY & NEPHROLOGY
A. Aref, Zohreh Zandbaf, A. Ghorbani, Shahla Ahmadi Halili
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引用次数: 0

摘要

导读:导管相关性感染是使用隧道中心静脉导管的血液透析患者的常见并发症,也是其发病和死亡的主要原因。导管相关感染的管理和预防的最佳策略尚不清楚。目的:评价半永久性置管前单剂量预防性万古霉素预防导管相关性感染的效果。患者和方法:本随机双盲对照临床试验对Ahvaz Golestan医院收治的需要血液透析并插入双腔中心静脉导管的慢性肾功能衰竭患者进行了研究。干预组(n=30)在置管前1小时静脉给予万古霉素1 g,对照组(n=30)给予等量生理盐水。观察6个月内导管相关感染及其他并发症的发生率。结果:随访6个月,万古霉素组9例(30.0%)因导管相关感染住院,需要使用抗生素,对照组14例(46.7%)(P=0.184)。万古霉素组因感染拔管4例(13.3%),对照组6例(20.7%),差异有统计学意义(P=0.451)。两组除感染外并发症4例(13.3%)(P=1.000)。对照组和万古霉素组的平均感染发生时间分别为2.43±0.38个月和3.85±0.42个月(P=0.002)。结论:虽然在双腔血液透析置管前1小时单剂量静脉注射万古霉素对预防6个月以上导管相关性感染的效果不显著,但明显延缓了感染的发生。试验注册:试验方案已获得伊朗临床试验注册中心批准(伦理代码:IR.AJUMS.HGOLESTAN.REC.1399.106, IRCT代码:IRCT20201206049617N1;https://www.irct.ir/trial/52832)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of single dose prophylactic vancomycin before semi-permanent catheterization to prevent catheter related infection; a randomized controlled trial, phase II
Introduction: Catheter-related infections are a common complication and a major cause of morbidity and mortality in hemodialysis patients with tunneled central venous catheters. The optimal strategy for the management and prevention of catheter-related infections is unclear. Objectives: This study is aimed to evaluate the single-dose prophylactic vancomycin efficacy before semi-permanent catheterization to prevent catheter-related infection. Patients and Methods: This randomized double-blind controlled clinical trial was conducted on patients with chronic renal failure requiring hemodialysis and insertion of a double-lumen central venous catheter admitted to Ahvaz Golestan Hospital. The intervention group (n=30) received 1 g of vancomycin intravenously one hour before catheter insertion and the control group (n=30) received an equal amount of normal saline. The incidence of catheter-related infections and other complications for 6 months was evaluated. Results: During the 6-month follow-up, hospitalization due to catheter-related infection and the need for antibiotic administration was observed in 9 patients (30.0%) who received vancomycin and 14 patients (46.7%) in the control group (P=0.184). Catheter extraction due to infection was observed in 4 patients of the vancomycin group (13.3%) and 6 patients of the control group (20.7%) (P=0.451). Complications other than infection were observed in four patients (13.3%) in each group (P=1.000). The mean time to onset of infection was 2.43 ±0.38 months in the control group and 3.85 ± 0.42 months in the vancomycin group (P=0.002). Conclusion: Although a single dose of intravenous vancomycin one hour before insertion of a bi-luminal hemodialysis catheter did not show a significant effect on preventing catheter-related infections over 6 months, it significantly delayed the onset of infection. Trial Registration: The trial protocol was approved by Iranian Registry of Clinical Trial (Ethical code: IR.AJUMS.HGOLESTAN.REC.1399.106 and IRCT code: IRCT20201206049617N1; https://www.irct.ir/trial/52832).
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来源期刊
Journal of Renal Injury Prevention
Journal of Renal Injury Prevention UROLOGY & NEPHROLOGY-
CiteScore
1.60
自引率
0.00%
发文量
36
期刊介绍: The Journal of Renal Injury Prevention (JRIP) is a quarterly peer-reviewed international journal devoted to the promotion of early diagnosis and prevention of renal diseases. It publishes in March, June, September and December of each year. It has pursued this aim through publishing editorials, original research articles, reviews, mini-reviews, commentaries, letters to the editor, hypothesis, case reports, epidemiology and prevention, news and views and renal biopsy teaching point. In this journal, particular emphasis is given to research, both experimental and clinical, aimed at protection/prevention of renal failure and modalities in the treatment of diabetic nephropathy. A further aim of this journal is to emphasize and strengthen the link between renal pathologists/nephropathologists and nephrologists. In addition, JRIP welcomes basic biomedical as well as pharmaceutical scientific research applied to clinical nephrology. Futuristic conceptual hypothesis that integrate various fields of acute kidney injury and renal tubular cell protection are encouraged to be submitted.
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