***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: ABSTRACT The aim of the present study was to determine the efficacy of an antibiotic-lock technique in preventing endoluminal catheter-related infection with gram-positive bacteria in neutropenic patients with hematologic malignancies . Patients with nontunneled , multilumen central venous catheters were assigned in a r and omized , double-blinded manner to receive either 10 U of heparin per ml  ( 57 patients )  or 10 U of heparin per ml and 25 μg of vancomycin per ml  ( 60 patients ) , which were instilled in the catheter lumen and which were allowed to dwell in the catheter lumen for 1 h every 2 days . Insertion-site and hub swabs were taken twice weekly . The primary and secondary end points of the trial were significant colonization of the catheter hub and catheter-related bacteremia , respectively . Significant colonization of the catheter hub occurred in nine ( 15.8 % ) patients receiving heparin ( seven patients were colonized with Staphylococcus epidermidis , one patient was colonized with Staphylococcus capitis , and one patient was colonized withCorynebacterium sp. ) , whereas the catheter hubs of none of the patients receiving heparin and vancomycin were colonized ( P = 0.001 ) . Catheter-related bacteremia developed in four ( 7 % ) patients receiving heparin ( three patients had S. epidermidis bacteremia and one patient had S. capitisbacteremia ) , whereas none of the patients in the heparin and vancomycin group had catheter-related bacteremia ( P = 0.05 ) . The times to catheter hub colonization and to catheter-related bacteremia by the Kaplan-Meier method were longer in patients receiving heparin and vancomycin than in patients receiving heparin alone ( P = 0.004 and P = 0.06 , respectively ) . Our study shows that a solution containing heparin and vancomycin administered by using an antibiotic-lock technique  effectively prevents catheter hub colonization with gram-positive bacteria and subsequent bacteremia during chemotherapy-induced neutropenia in patients with hematologic malignancy BACKGROUND We compared the rates of infection in external catheters ( ECs ) and totally implantable devices ( TIDs ) and the effect of timing of insertion in children with acute lymphoblastic leukemia ( ALL ) . PROCEDURE Central line data was collected on all children with ALL referred to the National Guard Hospital , Jeddah . Data was collected retrospectively from 1996 to September 1999 and prospect ively thereafter . Only ECs were inserted prior to 1999 subsequently TIDs were preferred . RESULTS One hundred forty eight children with ALL , mean age 5.1 years had 129 ECs and 70 TIDs inserted for a total of 41,382 catheter days . The overall rate of infective episodes ( infections/1,000 catheter days ) was 3.43 . Of the initial 148 lines 100 developed complications of which 76 ( 51 % ) were secondary to an infective episode . Only young age and treatment protocol were risk factors for first line infections ( P < 0.05 ) . There was weak evidence that ECs had an earlier time to infection compared to TIDs ( P = 0.056 ) . CONCLUSIONS In this study , population central lines were associated with a high rate of infection . Treatment protocol and age were the only significant risk factors when only first lines were considered . Delaying catheter insertion for more than 3 weeks from diagnosis did not reduce the risk of infection Objective .Critically ill neonates are at high risk for vascular catheter – related bloodstream infection ( CRBSI ) , most often caused by coagulase-negative staphylococci . Most CRBSIs with long-term devices derive from intraluminal contaminants . The objective of this study was to ascertain the safety and the efficacy of a vancomycin-heparin lock solution for prevention of CRBSI . Methods .A prospect i ve , r and omized double-blind trial was conducted during 2000–2001 at a community hospital level III NICU . Very low birth weight and other critically ill neonates with a newly placed peripherally inserted central venous catheter were r and omized to have the catheter locked 2 or 3 times daily for 20 or 60 minutes with heparinized normal saline ( n = 43 ) or heparinized saline that contained vancomycin 25 μg/mL ( n = 42 ) . The origin of each nosocomial bloodstream infection ( BSI ) was studied by culturing skin , catheter hubs , and implanted catheter segments and blood cultures , demonstrating concordance by restriction-fragment DNA subtyping . Surveillance axillary and rectal cultures were performed to detect colonization by vancomycin-resistant organisms . The main outcome measures were ( 1 ) CRBSIs and ( 2 ) colonization or infection by vancomycin-resistant Gram-positive bacteria . Results .Two ( 5 % ) of 42 infants in the vancomycin-lock group developed a CRBSI as compared with 13 ( 30 % ) of 43 in the control group ( 2.3 vs 17.8 per 1000 catheter days ; relative risk : 0.13 ; 95 % confidence interval : 0.01–0.57 ) . No vancomycin-resistant enterococci or staphylococci were recovered from any cultures . Vancomycin could not be detected in the blood of infants who did not receive systemic vancomycin therapy . Twenty-six neonates ( 8 vancomycin-lock group , 18 control group ) had at the end of a catheter-lock period asymptomatic hypoglycemia that resolved promptly when glucose-containing intravenous fluids were restarted . Conclusions .Prophylactic use of a vancomycin-heparin lock solution markedly reduced the incidence of CRBSI in high-risk neonates with long-term central catheters and did not promote vancomycin resistance but was associated with asymptomatic hypoglycemia . The use of an anti-infective lock solution for prevention of CRBSI with long-term intravascular devices has achieved proof of principle and warrants selective application in clinical practice In this prospect i ve cohort study , minocycline-ethylenediaminetetraacetate ( M-EDTA ) was used as a lock solution in indwelling ports inserted in 14 children with cancer . No port infections , thrombotic events , or other adverse events were observed , compared with 10 port infections that occurred in 48 control patients whose ports were flushed with heparin . M-EDTA is a promising lock solution in long-term catheters The aim of this study was to determine the efficacy of novobiocin and rifampin as oral antibiotic prophylaxis for the prevention of catheter‐related infection in melanoma patients treated with interleukin‐2 ( IL‐2 ) plus interferon‐α and chemotherapy ( biochemotherapy ) OBJECTIVE To determine whether adding vancomycin to central venous catheter ( CVC ) flush solution would significantly reduce the incidence of bacteremia attributable to luminal colonization with vancomycin-susceptible organisms . STUDY DESIGN Fifty-five children with cancer and eight children given total parenteral nutrition by the surgery or nutrition support services were r and omly assigned to receive a heparin CVC flush solution ( n = 31 ) or a heparin-vancomycin CVC flush solution ( n = 32 ) . RESULTS During 9158 catheter days , 6.5 % of the patients in the heparin group and 15.6 % of the patients in the heparin-vancomycin group had bacteremia attributable to luminal colonization with vancomycin-susceptible organisms ( p = 0.43 ) . The mean rates of bacteremia attributable to luminal colonization with vancomycin-susceptible organisms were 0.6/1000 catheter days in the heparin group and 1.4/1000 catheter days in the heparin-vancomycin group ( p = 0.25 ) . There was no significant difference between the groups when the time to the first episode of bacteremia attributable to luminal colonization with a vancomycin-susceptible organism was compared by means of Kaplan-Meier survival estimates . Streptococcus viridans infection was not attributable to luminal colonization . CONCLUSION The addition of vancomycin to heparin CVC flush solution did not reduce bacteremia with vancomycin-susceptible organisms . Bacteremia with Streptococcus viridans was not related to the use of a CVC Taurolidine has demonstrated inhibition of biofilm formation in vitro . The aim of this study was to compare the effect of catheter locking with taurolidine vs heparin in biofilm formation in central venous catheters . Forty‐eight children with cancer were r and omized to catheter locking by heparin ( n = 22 ) or taurolidine ( n = 26 ) , respectively . After removal , catheters were examined by st and ardized scanning electron microscopy to assess quantitative biofilm formation . Biofilm was present if morphologically typical structures and bacterial cells were identified . Quantitative and semi‐quantitative cultures were also performed . Biofilm was identified in 23 of 26 catheters from the taurolidine group and 21 of 22 catheters from the heparin group . A positive culture was made of six of the catheters locked with taurolidine and heparin , respectively ( p = 0.78 ) . The rate of catheter‐related bloodstream infections ( CRBSI ) was 0.1 per 1000 catheter‐days using taurolidine and 0.9 per 1000 catheter‐days using heparin ( p = 0.03 ) . This r and omized trial confirmed that the use of taurolidine as catheter‐lock compared with heparin reduced the rate of CRBSIs ; this reduction was not related to a reduction in the intraluminal biofilm formation and the rate of bacterial colonization detected by scanning electron microscopy in the two groups Abstract : In all , 88 patients with haematological malignancies requiring Hickman catheters for intensive chemotherapy were r and omized to receive either one single bolus intravenous injection of teicoplanin , 400 mg , or no teicoplanin immediately before insertion of a double‐lumen Hickman catheter . Lower incidences of catheter‐related Gram‐positive sepsis were recorded in patients receiving prophylactic teicoplanin ; exit site infection , tunnel infection and catheter‐related Gram‐positive septicaemia were all reduced . The benefit of prophylactic teicoplanin was observed particularly among patients who were already neutropenic at the time of catheterization . All Gram‐positive organisms isolated from infected skin sites or from blood cultures taken from Hickman catheters were susceptible to teicoplanin . No adverse reaction was reported in any of the patients receiving prophylaxis . Prophylactic teicoplanin , therefore , may be used routinely for patients requiring insertion of Hickman catheters for intensive chemotherapy , to reduce the early incidence of catheter‐related sepsis , particularly during the period of neutropenia following chemotherapy Prospect ively since 11/1997 , all central venous catheter related bacteremias in our dialysis center ( n = 60 ) was recorded . We systematic ally tested antibiotic lock technique using pure heparin ( 1 ml = 5000 Ul ) mixed with antibiotic matched to isolated micro-organism after 15 days of systemic antibiotherapy . During 39 months of study , 27 bacteremias were documented from 23 patients . Seventeen locks in 15 patients were performed after each dialysis sessions during one month . Associated tunnel infection did not allow to stop the lock in 3 cases . In the 12 remaining patients , we observed 4 recurrences for 3 patients after the stop of the lock with the same micro-organism in 3 times/4 without modifications of antibiotics sensibility . No septic metastases were notified and the patency of all catheters were respected . The incidence of bacteremias was 4.6 per 1000 catheters days before the lock and 0.88 after , during a mean observation period of 15 months per patients . Sterilisation of infected catheters seems possible and the incidence of bacteremias is reduce by the lock technique without coming out of septic complications or selected micro-organisms Background Taurolidin/Citrate ( TauroLock ™ ) , a lock solution with broad spectrum antimicrobial activity , may prevent bloodstream infection ( BSI ) due to coagulase-negative staphylococci ( CoNS or ' MRSE ' in case of methicillin-resistant isolates ) in pediatric cancer patients with a long term central venous access device ( CVAD , Port- or/Broviac-/Hickman-catheter type ) . Methods In a single center prospect i ve 48-months cohort study we compared all patients receiving anticancer chemotherapy from April 2003 to March 2005 ( group 1 , heparin lock with 200 IU/ml sterile normal saline 0.9 % ; Canusal ® Wockhardt UK Ltd , Wrexham , Wales ) and all patients from April 2005 to March 2007 ( group 2 ; taurolidine 1.35%/Sodium Citrate 4 % ; TauroLock ™ , Tauroph 
    Output:
    
There was no benefit to administering antibiotics before the insertion of long-term CVCs to prevent Gram positive catheter-related infections .
Flushing or locking long-term CVCs with a combined antibiotic and heparin solution appeared to reduce Gram positive catheter-related sepsis experienced in people at risk of neutropenia through chemotherapy or disease .
Due to insufficient data it was not clear whether this applied equally to TCVCs and totally implanted devices ( TIDs ) , or equally to adults and children .