Intravascular
catheter-associated
bloodstream infections significantly increase rates of morbidity and hospital costs. Microbial colonization and development of biofilms, which are known to be recalcitrant to
antibiotic therapy, often lead to the loss of otherwise patent vascular access systems. We evaluated a new
taurolidine- and
citrate-based
catheter lock
solution (Neutrolin; Biolink Corporation, Norwell, Mass.) for its activity against planktonic microbes, antimicrobial activity in a
catheter model, and biofilm eradication activity. In studies of planktonic microbes, after 24 h of contact, 675 mg of
taurolidine-
citrate solution per liter caused > 99% reductions in the initial counts of Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Entercoccus faecalis. A
solution of 13,500 mg/liter was cidal for Candida albicans. Ports and attached
catheters inoculated with 50 to 600 CFU of these bloodstream isolates per ml were locked with
heparin or the
taurolidine-
citrate solution. After 72 h, there was no growth in the
taurolidine-
citrate-treated devices but the
heparin-treated devices exhibited growth in the range of 6 x 10(2) to 5 x 10(6) CFU/ml. Biofilms were developed on
silicone disks in modified Robbins devices with broth containing 6% serum (initial counts, 10(6) to 10(8) CFU/cm(2)). The axenic biofilms were treated for 24 h with
taurolidine-
citrate or
heparin.
Taurolidine-
citrate exposure resulted in a median reduction of 4.8 logs, whereas
heparin treatment resulted in a median reduction of 1.7 logs (P < 0.01). No significant differences in the effects of the two treatments against P. aeruginosa and C. albicans were observed. These findings suggest that
taurolidine-
citrate is a promising combination agent for the prevention and treatment of intravascular
catheter-related infections.