Effect of ethanol/trisodium citrate lock on microorganisms causing hemodialysis catheter-related infections.

Abstract

PURPOSE:

This in vitro study tested the effectiveness of a novel 30% ethanol/4% trisodium citrate (TSC) lock solution against the most common pathogens causing hemodialysis catheter-related infections.

METHODS:

Clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) (n = 4), methicillin-sensitive S. aureus (MSSA) (n = 8), methicillin-resistant Staphylococcus epidermidis (MRSE) (n = 8), Pseudomonas aeruginosa (n = 4) and Escherichia coli (n = 4) were tested in duplicate. Bacterial suspensions of each isolate were made in a control solution of normal saline and Mueller-Hinton broth (MHB), and in a lock solution of ethanol 30%, TSC 4% and MHB. Suspensions were incubated at 37 degrees C for 48 h. Colony counts were determined from samples collected at t = 0 h (before exposure to the ethanol/TSC lock), t = 1 h (one hour after exposure to the ethanol/TSC lock), t = 24 h and t = 48 h. To confirm the absence of viable organisms in the lock solution, the remaining volume at 48 h was filtered through a 0.45 microm filter. The filter was rinsed with 15 mL sterile water and plated on tryptic soy agar (TSA).

RESULTS:

All controls demonstrated significant growth over 48 h. In the lock solutions, initial inocula were reduced to 0 viable colonies by t = 1 h (6-log kill), and there was no growth at t = 24 and 48 h. Filtering of lock solutions also showed no growth. These results were consistent among duplicates of all isolates.

CONCLUSIONS:

The 30% ethanol/4% TSC lock solution consistently eradicated MRSA, MSSA, MRSE, P. aeruginosa and E. coli within 1 h of exposure. Experiments are currently underway to test this novel lock solution on preventing biofilm production by these pathogens.

• Authors: T A Takla, S A Zelenitsky, L M Vercaigne
• Journal: The journal of vascular access (J Vasc Access) 2007 Oct-Dec Vol. 8 Issue 4 Pg. 262-7 ISSN: 1129-7298 [Print] United States
• PMID: 18161672 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Citrates
• trisodium citrate
• Ethanol

Topics

• Anti-Bacterial Agents (pharmacology)
• Bacterial Infections (etiology, microbiology, prevention & control)
• Catheters, Indwelling (microbiology)
• Citrates (pharmacology)
• Colony Count, Microbial
• Escherichia coli (drug effects, growth & development)
• Ethanol (pharmacology)
• Methicillin Resistance
• Pseudomonas aeruginosa (drug effects, growth & development)
• Renal Dialysis (adverse effects, instrumentation)
• Staphylococcus aureus (drug effects, growth & development)
• Staphylococcus epidermidis (drug effects, growth & development)
• Time Factors