Total parenteral (intravenous) nutrition in the home setting (Home TPN or HPN) is a life
saving strategy in patients who suffer from severe intestinal failure. Unfortunately, this
treatment modality remains complicated by the development of frequent infectious
complications. This especially relates to the device that is used to establish venous access,
mostly a catheter (Hickman-Broviac type) or a port-a-cath.
Taurolodine is an antimicrobial agent without any known side effects or resistance-related
problems that holds promise as an effective antibiotic lock solution to prevent catheter
infections, as demonstrated recently in a pilot study in HPN patients [Jurewitsch, 2005].
In addition, recently a test has been described which may enable to confirm a suspected
diagnosis of central line infection within one hour, the so-called Acridine Orange Leukocyte
Cytospin test (AOLC) [Bong, 2003]. For this test, blood that is drawn from the central line
is stained with the fluorescent dye acridine orange. Next, microscopic evaluation for the
presence of micro-organisms takes place. Implementation of this test might enable to start
treatment of the infection and prevent unnecessary removal of non-infected central lines
without the necessity to several days wait for culture results.