Efficacy of catheter lock solutions on central-line associated bloodstream infections (CLABSI) prevention: A systematic review and Bayesian network meta-analysis

Catheter lock solutions (CLs) are commonly used to reduce the risk of central line-associated bloodstream infections (CLABSI), but it remains uncertain which type is most beneficial for patients. This systematic review and Bayesian network meta-analysis synthesized available evidence by comparing different CLs directly and indirectly to prevent CLABSI and rank their effectiveness. A comprehensive search was performed across PubMed, Embase, Ovid, Scopus, Cochrane Library, and Google Scholar. After screening 2359 records by title and abstract and reviewing 374 full-text articles, 39 studies were included, covering seven CLs types. Bayesian network meta-analysis was conducted using STATA and ADDIS. Results showed that taurolidine-based (TCLs), ethanol-based (ECLs), gentamicin-based (GCLs), and EDTA-based (EDTA-CLs) solutions were more effective than saline or heparin in preventing CLABSI. According to the surface under the cumulative ranking curve (SUCRA), TCLs had the highest probability of reducing CLABSI (89.1%), followed by GCLs (82.6%) and EDTA-CLs (72.6%). In conclusion, this review underscores the clinical value of catheter lock solutions in CLABSI prevention, with strong evidence supporting the integration of TCLs into central venous catheter maintenance bundles due to their significant benefits.