EFEK PEMBERIAN HEPARIN LOCK DAN ANTIBIOTIK TOPIKAL PADA PASIEN PENYAKIT GINJAL KRONIS YANG TERPASANG KATETER DOBEL LUMEN JANGKA PENDEK DENGAN KEJADIAN CATHETER RELATED BLOODSTREAM INFECTION (CRBSI)

Introduction: Catheter-related bloodstream infection (CRBSI) is a complication that can occur in hemodialysis patients, especially when a double-lumen catheter (DLC) is used. This study aimed to investigate the effect of heparin lock and topical antibiotics on the incidence of CRBSI in chronic kidney disease (CKD) patients using DLC.
Methods: This randomized, pre–post-control design study was conducted on adult patients undergoing routine hemodialysis. Patients were divided equally into two groups. In addition to the standard protocol, the first group was given a combination therapy of heparin lock (20 mg/mL heparin left in DLC for 4 hours) and mupirocin 5% cream at the DLC exit area, and the second group was only given a single heparin lock. The diagnosis of CRBSI was made based on the Infectious Diseases Society of America criteria. Numerical data were analyzed using the t-test and Mann–Whitney U test. Categorical data were analyzed using the chi-square test. A p-value of <0.05 was considered significant.
Results: Of the 40 patients (20 male and 20 female) in this study, 62.5% were between the ages of 41–60 years. CRBSI was found in 10 patients (25%), with a higher incidence in the single-therapy group (8 cases; p < 0.05). The single-therapy group also tended to have CRBSI faster, with a hazard ratio of 7.61.
Conclusion: The application of the topical antibiotic mupirocin might be effective in reducing the risk of CRBSI in CKD patients using DLC.