Alonso B, Pérez-Granda MJ, Latorre MC Production of biofilm by staphylococcus aureus: association with infective endocarditis?. Enferm Infecc Microbiol Clin. 2022; 40:(8)418-422

Arunan B, Ahmed NH, Kapil A Central Line-Associated Bloodstream Infections: Effect of Patient and Pathogen Factors on Outcome. J Glob Infect Dis. 2023; 15:(2)59-65

Bering J, DiBaise JK. Short bowel syndrome: complications and management. Nutr Clin Pract. 2023; 38:S46-S58

Casimero C, Ruddock T, Hegarty C, Barber R, Devine A, Davis J. Minimising blood stream infection: developing new materials for intravascular catheters. Medicines (Basel). 2020; 7:(9)

Chrissoheris MP, Libertin C, Ali RG, Ghantous A, Bekui A, Donohue T. Endocarditis complicating central venous catheter bloodstream infections: a unique form of health care associated endocarditis. Clin Cardiol. 2009; 32:(12)E48-54

Climo M, Diekema D, Warren DK Prevalence of the use of central venous access devices within and outside of the intensive care unit: results of a survey among hospitals in the prevention epicenter program of the Centers for Disease Control and Prevention. Infect Control Hosp Epidemiol. 2003; 24:(12)942-5

Dutta S, Bhattacharjee J. A review on the contamination caused by bacterial biofilms and its remediation. In: Shah MP (ed). Amsterdam, Netherlands: Elsevier; 2022

Eggimann P, Pagani JL, Dupuis-Lozeron E Sustained reduction of catheter-associated bloodstream infections with enhancement of catheter bundle by chlorhexidine dressings over 11 years. Intensive Care Med. 2019; 45:(6)823-833

Gattini D, Yan H, Belza C, Avitzur Y, Wales PW. Cost-utility analysis of 4% tetrasodium ethylenediaminetetraacetic acid, taurolidine and heparin lock to prevent central line-associated bloodstream infections in children with intestinal failure. JPEN J Parenter Enteral Nutr. 2023;

Gorski LA, Hadaway L, Hagle ME Infusion Therapy Standards of Practice. J Infus Nurs. 2021; 44:(1S)S1-S224

Hill J, Garner R. Efficacy of 4% tetrasodium ethylenediaminetetraacetic acid (T-EDTA) catheter lock solution in home parenteral nutrition patients: a quality improvement evaluation. J Vasc Access. 2021; 22:(4)533-539

Labriola L. Antibiotic locks for the treatment of catheter-related blood stream infection: Still more hope than data. Semin Dial. 2019; 32:(5)402-405

Lemiech-Mirowska E, Kiersnowska ZM, Michałkiewicz M, Depta A, Marczak M. Nosocomial infections as one of the most important problems of healthcare system. Ann Agric Environ Med. 2021; 28:(3)361-366

Manjula S. CLABSI (Central line-associated blood stream infection). Asian Journal of Nursing Education and Research. 2022; 12:(3)353-355

Moureau N, Poole S, Murdock MA, Gray SM, Semba CP. Central venous catheters in home infusion care: outcomes analysis in 50,470 patients. J Vasc Interv Radiol. 2002; 13:(10)1009-1016

Moureau NL. Vessel health and preservation: the right approach for vascular access.Cham (Switzerland): Springer Nature; 2019

Pérez-Granda MJ, Bouza E, Pinilla B Randomized clinical trial analyzing maintenance of peripheral venous catheters in an internal medicine unit: Heparin vs. saline. PLoS One. 2020; 15:(1)

Pironi L, Boeykens K, Bozzetti F ESPEN guideline on home parenteral nutrition. Clin Nutr. 2020; 39:(6)1645-1666

Platt V, Osenkarski S. Improving vascular access outcomes and enhancing practice. J Infus Nurs. 2018; 41:(6)375-382

Quirt J, Belza C, Pai N Reduction of central line-associated bloodstream infections and line occlusions in pediatric intestinal failure patients receiving long-term parenteral nutrition using an alternative locking solution, 4% tetrasodium ethylenediaminetetraacetic acid. JPEN J Parenter Enteral Nutr. 2021; 45:(6)1286-1292

Rickard CM, Ullman AJ. Bloodstream infection and occlusion of central venous catheters in children. Lancet Infect Dis. 2018; 18:(8)815-817

Santomauro I, Campani D, Tiozzo V Heparin versus normal saline locking for prevention of occlusion, catheter-related infections and thrombosis in central venous catheter in adults: Overview of systematic reviews. J Vasc Access. 2022;

Sharma D, Misba L, Khan AU. Antibiotics versus biofilm: an emerging battleground in microbial communities. Antimicrob Resist Infect Control. 2019; 8

Simmons EL, Bond MC, Koskella B, Drescher K, Bucci V, Nadell CD. Biofilm structure promotes coexistence of phage-resistant and phage-susceptible bacteria. MSystems. 2020; 5:(3)10-1128

Steere L. CLE3AR study: 5-Year impact of LEAN central venous catheter occlusion management & quality interventions. Clin Nurse Spec. 2022; 36:(2)92-98

van den Bosch CH, Jeremiasse B, van der Bruggen JT The efficacy of taurolidine containing lock solutions for the prevention of central-venous-catheter-related bloodstream infections: a systematic review and meta-analysis. J Hosp Infect. 2022; 123:143-155

Vestby LK, Grønseth T, Simm R, Nesse LL. Bacterial biofilm and its role in the pathogenesis of disease. Antibiotics (Basel). 2020; 9:(2)

KiteLock 4%: the next generation of CVAD locking solutions

25 January 2024
Volume 33 · Issue 2


Central venous access devices (CVADs), including peripherally inserted central catheters (PICCs) and cuffed tunnelled catheters, play a crucial role in modern medicine by providing reliable access for medication and treatments directly into the bloodstream. However, these vital medical devices also pose a significant risk of catheter-related bloodstream infections (CRBSIs) alongside associated complications such as thrombosis or catheter occlusion. To mitigate these risks, healthcare providers employ various strategies, including the use of locking solutions in combination with meticulous care and maintenance protocols. KiteLock 4% catheter lock is a solution designed to combat the triple threat of infection, occlusion and biofilm. This locking solution is described as the only locking solution to provide cover for all three complications.

Catheter-related bloodstream infections (CRBSIs) are a serious complication associated with central venous catheters, frequently caused by microbial colonisation at the catheter site or migration of pathogens from distant sources. These infections can lead to life-threatening conditions, including sepsis, endocarditis, and abscess formation. Consequently, CRBSIs create challenges for both patients and healthcare providers. Various strategies have been developed to minimise the occurrence of CRBSIs, including the use of catheter-locking solutions. These solutions act as antimicrobial agents, and some can prevent the thrombus formation that can cause occlusion and/or biofilms to reduce microbial colonisation within the catheter lumen.

According to a study by Lemiech-Mirowska et al (2021), the prevalence of hospital-acquired or nosocomial infections exceeds 25% in developing countries and is up to 15% in developed countries, resulting in the death of approximately 40 000 hospitalised patients worldwide. It is well documented that up to 90% of inpatients have some form of vascular access device placed during the course of their hospital stay (Platt and Osenkarski, 2018). For most patients, this could be the most invasive procedure they would have experienced, so to reduce the risk of associated complications, it is vital that all measures are taken to protect the catheter in order to protect the patient.

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