Abstract

Dr. K. Sree Harsha Vardhan*, Dr. Manjusha Yadla, Dr. P. Srinivas

ABSTRACT

Background: Catheter-related bloodstream infection (CRBSI) is an important complication of central venous catheter use in patients receiving hemodialysis. Antibiotic lock therapy is intended to reduce intraluminal microbial persistence and may improve catheter salvage and longevity. Objective: To describe the clinical profile and outcomes of culture-positive CRBSI patients managed with and without antibiotic lock therapy. Methods: This retrospective observational study included 158 patients with culture-positive CRBSI admitted to Gandhi Hospital between January 2024 and December 2025. Patients had tunneled or non-tunneled catheters. Gentamicin lock therapy, when used, was administered after each hemodialysis session using gentamicin sulfate diluted with 0.9% sodium chloride, with the lock volume corresponding to the internal catheter-lumen volume. Results: The mean age was 54.96 ± 8.90 years and 67.7% of patients were male. Non-tunneled catheters accounted for 55.7% and tunneled catheters for 44.3%. Staphylococcus aureus was the most frequent isolate (29.1%), followed by coagulase-negative staphylococci (24.1%). In the comparison presented in the source dataset, time to first CRBSI was longer with lock therapy for both non-tunneled catheters (31 ± 6 vs. 18 ± 3 days, p < 0.001) and tunneled catheters (96 ± 14 vs. 62 ± 10 days, p < 0.001). ICU admission occurred in 16 patients in the lock group and 38 in the no-lock group; overall mortality was 3.0% versus 7.6%, respectively, although the mortality difference was not statistically significant (p = 0.221). Conclusion: In this retrospective cohort, antibiotic lock therapy was associated with longer catheter-related infection-free duration and fewer severe hospitalization outcomes, while a statistically significant mortality benefit was not demonstrated. These findings support further prospective evaluation of antibiotic lock strategies in catheter-dependent hemodialysis populations.