***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: 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 ™ , Tauropharm , Waldbüttelbrunn , Germany ) . Results In group 1 ( heparin ) , 90 patients had 98 CVAD in use during the surveillance period . 14 of 30 ( 47 % ) BSI were ' primary Gram positive BSI due to CoNS ( n = 4 ) or MRSE ( n = 10 ) ' [ incidence density ( ID ) ; 2.30 per 1000 inpatient CVAD-utilization days].In group 2 ( TauroLock ™ ) , 89 patients had 95 CVAD in use during the surveillance period . 3 of 25 ( 12 % ) BSI were caused by CoNS . ( ID , 0.45 ) . The difference in the ID between the two groups was statistically significant ( P = 0.004 ) . Conclusion The use of Taurolidin/Citrate ( TauroLock ™ ) significantly reduced the number and incidence density of primary catheter-associated BSI due to CoNS and MRSE in pediatric cancer patients BACKGROUND Bacteremia is a major cause of morbidity in patients using intravascular catheters . Interdialytic locking with antibiotics decreases the incidence of bacteremia , but risks antibiotic resistance . Taurolidine is a nontoxic broad-spectrum antimicrobial agent that has not been associated with resistance . Preliminary evidence suggests that taurolidine-citrate locks decrease bacteremia , but cause flow problems in established catheters . STUDY DESIGN Double-blind r and omized controlled trial . INTERVENTION Interdialytic locking with taurolidine and citrate ( 1.35 % taurolidine and 4 % citrate ) compared with heparin ( 5,000 U/mL ) started at catheter insertion . SETTING & PARTICIPANTS 110 adult hemodialysis patients with tunneled cuffed intravascular catheters inserted at 3 centers in Northwest Engl and . OUTCOMES & MEASUREMENTS Primary end points were time to first bacteremia episode from any cause and time to first use of thrombolytic therapy . RESULTS There were 11 bacteremic episodes in the taurolidine-citrate group and 23 in the heparin group ( 1.4 and 2.4 episodes/1,000 patient-days , respectively ; P = 0.1 ) . There was no significant benefit of taurolidine-citrate versus heparin for time to first bacteremia ( hazard ratio , 0.66 ; 95 % CI , 0.2 - 1.6 : P = 0.4 ) . Taurolidine-citrate was associated with fewer infections caused by Gram-negative organisms than heparin ( 0.2 vs 1.1 infections/1,000 patient-days ; P = 0.02 ) ; however , there was no difference for Gram-positive organisms ( 1.1 vs 1.2 infections/1,000 patient-days ; P = 0.8 ) . There was a greater need for thrombolytic therapy  in the taurolidine-citrate versus heparin group ( hazard ratio , 2.5 ; 95 % CI , 1.3 - 5.2 ; P = 0.008 ) . LIMITATIONS Small sample size . The study included bacteremia from all causes and was not specific for catheter-related bacteremia . CONCLUSIONS Taurolidine-citrate use did not decrease all-cause bacteremia and was associated with a greater need for thrombolytic treatment .  There was a decrease in infections caused by Gram-negative organisms and a trend to a lower frequency of bacteremia , which warrants further study Background : Use of uncuffed catheters ( UCs ) in hemodialysis patients is common practice . An antibiotic lock has been recommended to prevent catheter-related bacteremia ( CRB ) , although insufficient data are available about the appropriate antimicrobial agent and dose with prolonged use of UCs . Methods : This open-label r and omized study was conducted to compare gentamicin/heparin ( group A ) and taurolidine/citrate ( group B ) , as catheter-lock solutions , in 119 chronic hemodialysis patients in whom a total of 150 UCs were placed . A well-matched historical control group ( heparin ) included 67 UCs in 58 patients ( group C ) . Results : CRB episodes developed in 6 and 8 patients in groups A and B , respectively , significantly fewer than in group C ( 20 patients ) . Cumulative CRB-free catheter survival at 90 days was 82 % for A and 78 % for B , which is significantly higher than the 26 % for C. Similar Gram-positive infection rates were found in all groups . The Gram-negative infection rate was significantly lower in B compared to C. No significant differences in thrombosis rates were observed between the groups . Conclusions : Gentamicin/heparin and taurolidine/citrate , used for locking UC , were similarly effective at preventing CRB and catheter thrombosis for up to 3 months , until a functional permanent vascular access became available . Both antimicrobial lock solutions were superior to heparin in CRB prevention with similar thrombosis rates BACKGROUND The use of haemodialysis catheters is complicated by catheter-related sepsis . Intraluminal colonization of the catheter with bacteria is important in the pathogenesis of catheter-related sepsis . The use of a catheter lock solution containing the antimicrobial taurolidine might prevent bacterial colonization , thereby reducing the incidence of catheter-related sepsis . METHODS In a r and omized prospect i ve trial , patients receiving a dialysis catheter were included and catheters were locked with either heparin or a citrate-taurolidine-containing solution . Blood cultures drawn from the catheter lumen were routinely taken every 2 weeks and at time of removal of the catheter to detect bacterial colonization . Catheter-related sepsis and exit-site infections were registered for both groups . RESULTS A total of 76 catheters were inserted in 58 patients . The incidence of catheter colonization progressed slowly over time with no differences between dialysis catheters filled with heparin or citrate-taurolidine-containing solution . The number of exit-site infections was also similar between both groups . In the heparin group , four cases of catheter-related sepsis occurred as opposed to no sepsis episodes in the patients with catheters locked with the citrate-taurolidine-containing solution ( P<0.5 ) . No side effects with the use of citrate-taurolidine catheter lock solution were noted . CONCLUSIONS This study shows that catheter filling with a solution containing the antimicrobial taurolidine may significantly reduce the incidence of catheter-related sepsis .  Taurolidine appears to be effective and safe and does not carry the risk for side effects that have been reported for other antimicrobial lock solutions containing gentamicin or high concentrations of citrate BACKGROUND Intravenous catheters for haemodialysis increase the risk of sepsis . This study investigates the use of a taurolidine/citrate catheter-locking agent for patients receiving hospital-based haemodialysis , auditing the number and cost of infections before and after its introduction . METHODS The incidence and cost of treatment of catheter sepsis occurring in all patients receiving haemodialysis via a line were investigated over 6-month periods before and after introducing the taurolidine/citrate line-locking agent . RESULTS A reduction of 4.62 infections per 1000 catheter days , or 88.5 % , was shown after the introduction of the new line-locking agent . The total costs of line infections in the first 6 months were 52,500 euros , ( 41,000 pounds ) ; after the introduction of the taurolidine/citrate locks , these reduced to 33,300 euros , ( 26 , 000 pounds ) , a reduction of 19,200 euros ( 15,000 pounds ) . CONCLUSIONS The use of a taurolidine/citrate haemodialysis catheter-locking agent in our haemodialysis population has significantly reduced the line sepsis rate , with a positive impact on morbidity , mortality and cost BACKGROUND A catheter lock solution containing 1.35 % taurolidine and 4 % citrate could potentially disrupt bacterial surface adherence and consecutive biofilm production due to the anti-adherence properties of taurolidine and the anticlotting and chelator activities of both compounds . AIM To compare the impact on microbial catheter colonization and infectious complications of heparin and taurolidine citrate as central venous catheter ( CVC ) lock solutions in paediatric patients with haematological malignancies . METHODS Seventy-one patients aged 1.4 - 18 years were r and omized to two treatment groups using either heparin ( N = 36 ) or taurolidine citrate ( N = 35 ) . Infectious complications and clinical side-effects were prospect ively monitored and microbial colonization of catheters was assessed at the time of removal . FINDINGS There were two bloodstream infections in the taurolidine citrate group versus nine in the heparin group ( 0.3 vs 1.3 infections per 1000 catheter-days ; P = 0.03 ) . Fever of unknown origin and catheter occlusions were observed with a similar frequency in both groups . Microbial colonization was found in 25.4 % catheters . The time of no-lock use , but not the type of lock solution or time of observation , was a significant predictor of catheter colonization ( P = 0.004 ) . Colonization was not observed in CVCs used immediately with taurolidine citrate lock . Seven patients in the taurolidine citrate group ( 20 % ) experienced side-effects ( nausea , vomiting , abnormal taste sensations ) . CONCLUSION The use of taurolidine citrate lock solution was associated with a significant reduction in bloodstream infection in immunocompromised paediatric patients .  Taurolidine citrate may prevent colonization of CVCs if used from the time of insertion , but not after a period of no-lock catheter use 
    Output:
    
The results of this analysis indicated that taurolidine-citrate , compared to heparin , was more effective in preventing catheter-related infection ; therefore , it could be considered as a superior strategy .
Nevertheless , compared to heparin-gentamicin combination , taurolidine-citrate is an inferior strategy because of its higher cost and lower infection prevention .
CONCLUSION Compared to heparin , taurolidine-citrate is a superior option , but it is an inferior strategy compared to heparin-gentamicin combination .