A research nurse specialist completing her Masters in Health Sciences at the University of Otago, Christchurch has shown that using ethanol as a ‘disinfectant’ in intravenous catheters (plastic tubes fixed into patients’ veins for weeks or months in order to give drugs or blood) reduces blood stream infection rates in immune-suppressed patients.
Joanne Sanders has demonstrated for the first time that by using diluted ethanol (pharmaceutical grade alcohol), catheter-associated infection rates (CABSI) in patients having chemotherapy are four times lower compared to conventional methods.
“What really surprised us when we analysed the results was not that the patients with ethanol-lock catheters had fewer infections, but that the difference was so significant.”
“Only 9 per cent of patients administered ethanol developed infections in the blood, but in contrast four times as many, 37 per cent, of those who were given the placebo saline solution, developed bloodstream infections. Patients with infections have to be treated with antibiotics, or have the catheter removed and a new one put in; much more problematic in anyone who has had their immune systems suppressed.”
The research, which was supervised by Drs Alan Pithie and Peter Ganly at Christchurch Hospital, looked at two groups of patients. 34 had ethanol locked into their central venous chest catheters for two hours every day to prevent infection, while 30 were given conventional treatment using a saline solution.
“It’s a very exciting result although in a relatively small sample of 64 patients,” she says. “However it’s generated a lot of interest both here and overseas as bloodstream infections can be life-threatening for patients who’ve been immuno-suppressed during chemotherapy for leukaemia, or those having a bone marrow transplant.”
Joanne says the ethanol seems to work well because it attacks all bacteria which have lodged in the biofilm on the inside of the catheter – unlike conventional antibiotics which only kill certain bacteria and have nowhere near the wide ranging hit rate of ethanol. The big plus is that it’s cheap, at about $4 per patient per day; much cheaper than trying to deal with infections in seriously ill patients.
This is the first study ever to demonstrate that ethanol can prevent catheter-associated blood infection, and the results have produced interest in the USA and Australia. Joanne expects further replication studies to be carried out.
This study has been published in the Journal of Antimicrobial Chemotherapy and was funded by the Canterbury District Health Board.
(Source: Journal of Antimicrobial Chemotherapy: University of Otago: October 2008)