{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:25:17Z","timestamp":1788884717165,"version":"build-2803163510"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To compare the efficacy and safety of antibiotic lock therapy (ALT) versus catheter removal in managing central vascular catheter\u2013associated bloodstream infection (CVC-BSI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a single-centre, retrospective cohort study of adult patients treated with ALT or catheter removal for management of CVC-BSI between 2018 and 2022. The primary outcome was a composite of 90 day microbiological relapse or recurrent BSI. Secondary outcomes included 30 day mortality, CVC-associated complications and Clostridioides difficile infection (CDI). Logistic regression with propensity score-adjustment was used to evaluate differences in outcomes and identify predictors of relapse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During the study period, 106 participants received ALT and 181 underwent catheter removal. Patients treated with ALT received shorter courses of systemic antimicrobials (11 versus 14\u2005days; P\u200a&amp;lt;\u200a0.001) and had shorter hospital stays (4 versus 10\u2005days; P\u200a&amp;lt;\u200a0.001). Median duration of catheter salvage in patients receiving ALT was 28\u2005days (IQR 7\u201380). Primary composite outcome was similar between both groups, but ALT was associated with a significantly higher risk of microbiological relapse within 90\u2005days (20% versus 7%; adjusted odds ratio 3.93, 95% CI 1.64\u20139.40; P\u200a=\u200a0.002). No significant difference in 30 day mortality, CVC-related complications or CDI was observed. CoNS BSI was an independent predictor of microbiological relapse in patients treated with ALT (OR 2.28; P\u200a=\u200a0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Although ALT offers a non-invasive catheter salvage strategy, its association with higher relapse rates, particularly in CoNS BSI, suggests catheter removal should remain the preferred approach when feasible. ALT could be considered a short-term catheter salvage strategy for pathogens with low virulence when used with close surveillance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkaf168","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T13:06:16Z","timestamp":1747832776000},"page":"2016-2024","source":"Crossref","is-referenced-by-count":4,"title":["Lines on the line: evaluating the impact of antibiotic lock therapy versus catheter removal in the management of central vascular catheter infections"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9538-6214","authenticated-orcid":false,"given":"Nischal","family":"Ranganath","sequence":"first","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic , Rochester, MN 55905 ,","place":["USA"]},{"name":"Division of Hospital Internal Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussam","family":"Tabaja","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic , Rochester, MN 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaisak O","family":"Nair","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic , Rochester, MN 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Dumais","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic , Rochester, MN 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5050-6689","authenticated-orcid":false,"given":"Ryan W","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalton","family":"Kind","sequence":"additional","affiliation":[{"name":"Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Lemahieu","sequence":"additional","affiliation":[{"name":"Division of Clinical Trials & Biostatistics, Department of Quantitative Health Sciences, College of Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"O\u2019Horo","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic , Rochester, MN 55905 ,","place":["USA"]},{"name":"Division of Pulmonary and Critical Care Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2023-394X","authenticated-orcid":false,"given":"Aditya","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic , Rochester, MN 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"2025070104563403000_dkaf168-B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1086\/599376","article-title":"Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America","volume":"49","author":"Mermel","year":"2009","journal-title":"Clin Infect Dis"},{"key":"2025070104563403000_dkaf168-B2","volume-title":"Bloodstream infection event (central line-associated bloodstream infection and non-central line-associated bloodstream infection)","author":"CDC","year":"2024"},{"key":"2025070104563403000_dkaf168-B3","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1001\/jama.1994.03510440058033","article-title":"Nosocomial bloodstream infection in critically ill patients. 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