P833 - USE OF TAUROLIDINE IN PREVENTING CATHETER-RELATED BLOOD STREAM INFECTIONS IN SPINAL CORD INJURY PATIENTS– A QUALITY IMPROVEMENT INITIATIVE TO REDUCE ADVERSE EFFECTS ASSOCIATED WITH PARENTERAL NUTRITION.

P833

USE OF TAUROLIDINE IN PREVENTING CATHETER-RELATED BLOOD STREAM INFECTIONS IN SPINAL CORD INJURY PATIENTS– A QUALITY IMPROVEMENT INITIATIVE TO REDUCE ADVERSE EFFECTS ASSOCIATED WITH PARENTERAL NUTRITION.

S. S. H. Wong^1,2,3,*, S. Swarna^1,2, S. Hirani³, V. Blackwell⁴, A. Forbes⁵, N. Hamilton⁶, A. Daulatzai⁶, G. Santiago¹, M. Layson¹, M. Woodley⁷, C. Hillier¹, S. Hariharan¹

¹National Spinal Injuries Centre, Stoke Mandeville Hospital, ²Royal Buckinghamshire Hospital, Aylesbury, ³Health Services Research, City St George's, University of London, London, ⁴Department of Gastroenterology, Stoke Mandeville Hospital, Aylesbury, United Kingdom, ⁵Institute of Clinical Medicine, University of Tartu, Tartu, Estonia, ⁶Department of Pharmacy, ⁷OPAT, Stoke Mandeville Hospital, Aylesbury, United Kingdom

Rationale: Patients with spinal cord injury (PWSCI) will require additional protein for pressure ulcer healing and supplementary bespoke (high protein, low calorie) parenteral nutrition (PN) use is increasingly common. However,, clinicians are concerned that the use of a long term catheter will increase the risk of catheter-related blood stream infection (CRBSI). Taurolidine, a chemical compound that has the potential to be used as a prophylactic for CRBSIs. The study's aim was to (1) assess if taurolidine can prevent CRBSIs in PWSCI on PN support.

Methods: Taurolidine was prescribed to all PWSCI starting PN in 2024 (n=8, taurolidine group). The data was compared to our retrospective study data conducted during January 2018 to December 2023 (control group). We defined CRBSI as the presence of bacteremia (positive culture report) from a peripheral vein and the intravenous catheter.²

Results: 2,002 adults (2019: n=373; 2020: n=243; 2021: n=339; 2022: n=343; 2023: n=335; 2024: n=369) with SCI were admitted during the study period. Thirty-eight PWSCI (1.9%) received PN support. Of 2,929 days of PN, nine confirmed CRBSIs. All nine CRBSIs were from the control group compared to zero CRBSI in taurolidine group. (Control: n=9, 4.36 CRBSIs per 1,000 PN days vs Taurolidine group: n=0, 0 CRBSI per 1,000 PN days)

Conclusion: This study suggests taurolidine has the potential to prevent CRBSIs in PWSCI on PN support. A confirmatory study, with adequate power (n=24), is needed to confirm this apparent therapeutic success to translate it into improved clinical outcomes.

References: Lai S et al (2018).  https://www.bapen.org.uk/pdfs/bifa/recommendations-for-crbsi-diagnosis.pdf   

NCEPOD (2010):  https://www.ncepod.org.uk/2010report1/downloads/PN_report.pdf 

Disclosure of Interest: None declared