Many children with cancer receive a central line. This is a thin tube inserted into a large blood vessel. We can use this line to take blood samples and administer fluids, nutrition, and medication. Unfortunately, these lines sometimes become infected with bacteria. This is called an infection. An infection is unpleasant and can sometimes even be dangerous. Your child will often need to be admitted to hospital for antibiotics. Sometimes the line even needs to be replaced in the operating theatre.
To prevent infections and blood clots, we close the line between two treatments with a liquid. We call this a ‘lock’. In the Netherlands, we use the heparin lock as standard. This prevents blood clots, but does not kill bacteria. The CATERPILLAR study investigated whether another lock – with taurolidine citrate heparin – works better against infections.
What did we study?
The study involved 463 children with cancer between 2020 and 2023. Half of the children received the standard heparin lock. The other half received the new taurolidine lock. We compared how many children in both groups developed an infection.
What are the results?
There was no clear difference in the number of infections between the two groups. The taurolidine lock did not work better than the standard lock. We did see that administering a lock more often or earlier might help prevent infections. However, more research is needed to confirm this.
What are the next steps?
For the time being, the standard heparin lock will remain the usual treatment for children with cancer. The taurolidine lock is not yet in standard use. We are still investigating whether this lock can help children with a higher risk of infection, or if we administer the taurolidine lock earlier or more often.
Would you like to read the scientific publication? Please look here: Van den Bosch CH, et al. The CATERPILLAR study: an assessor-blinded randomized controlled trial comparing a taurolidine-citrate-heparin lock solution to a heparin-only lock solution for the prevention of central-line-associated bloodstream infections in paediatric oncology patients. J Hosp Infect. 2024 Oct;152:56-65.