文献类型：期刊文献

英文题名：Does antimicrobial lock solution reduce catheter-related infections in hemodialysis patients with central venous catheters? A Bayesian network meta-analysis

作者：Zhang, Jun[1];Wang, Bo[2];Li, Rongke[1];Ge, Long[3];Chen, Kee-Hsin[4,5,6];Tian, Jinhui[3]

第一作者：张军

通信作者：Zhang, J[1];Tian, JH[2]

机构：[1]Gansu Univ Chinese Med, Sch Nursing, 35 Dingxi East Rd, Lanzhou 730000, Gansu, Peoples R China;[2]Rehabil Hosp Gansu Prov, Dept Nursing, 53 Dingxi Rd, Lanzhou 730000, Gansu, Peoples R China;[3]Lanzhou Univ, Evidence Based Med Ctr, 199 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China;[4]Taipei Med Univ, Taipei Municipal Wan Fang Hosp, Dept Nursing, 111,Sect 3,Hsing Long Rd, Taipei 116, Taiwan;[5]Taipei Med Univ, Taipei Municipal Wan Fang Hosp, Evidence Based Knowledge Translat Ctr, 111,Sect 3,Hsing Long Rd, Taipei 116, Taiwan;[6]Taipei Med Univ, Sch Nursing, 250 Wu Hsing St, Taipei 110, Taiwan

第一机构：甘肃中医药大学护理学院

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Sch Nursing, 35 Dingxi East Rd, Lanzhou 730000, Gansu, Peoples R China;[2]corresponding author), Lanzhou Univ, Evidence Based Med Ctr, 199 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China.|[107352f23a9081f8152fc]甘肃中医药大学护理学院;[10735]甘肃中医药大学;

年份：2017

卷号：49

期号：4

起止页码：701

外文期刊名：INTERNATIONAL UROLOGY AND NEPHROLOGY

收录：;Scopus(收录号：2-s2.0-85007484092);WOS:【SCI-EXPANDED(收录号:WOS:000398469800021)】；

语种：英文

外文关键词：Antimicrobial lock solution; Catheter-related infections; Central venous catheters; Network metaanalysis; Renal dialysis

摘要：Purpose The purpose of our study is to carry out a Bayesian network meta-analysis comparing the efficacy of different antimicrobial lock solutions (ALS) for prevention of catheter-related infections (CRI) in patients with hemodialysis (HD) and ranking these ALS for practical consideration. Methods We searched six electronic databases, earlier relevant meta-analysis and reference lists of included studies for randomized controlled trials (RCTs) that compared ALS for preventing episodes of CRI in patients with HD either head-to-head or against control interventions using non-ALS. Two authors independently assessed the methodological quality of included studies using the Cochrane risk of bias tool and extracted relevant information according to a predesigned extraction form. Data were analysed using the WinBUGS (V.1.4.3) and the Stata (V.13.0). Results Finally, 18 studies involving 2395 patients and evaluating 9 ALS strategies were included. Network meta-analysis showed that gentamicin plus citrate (OR 0.07, 95% CrI 0.00-0.48) and gentamicin plus heparin (OR 0.04, 95% CrI 0.00-0.23) were statistically superior to heparin alone in terms of reducing CRBSI. For exit site infection and all-cause mortality, no significant difference in the intervention effect (p > 0.05) was detected for all included ALS when compared to heparin. Moreover, all ALS were similar in efficacy (p > 0.05) from each other for CRBSI, exit site infection and all-cause mortality. Conclusions Our findings indicated that gentamicin plus heparin may be selected for the prophylaxis of CRI in patients undergoing HD with CVCs. Whether this strategy will lead to antimicrobial resistance remains unclear in view of the relatively short duration of included studies. More attentions should be made regarding head-to-head comparisons of the most commonly used ALS in this field.