Coagulase-Negative Staphylococcal Bacter- emia in Neonates: Can it be Successfully Treated with Vancomycin Without Removing Central Venous Catheters? Furigay PJ, Karlowicz MG, Croitoru DP, et al. J Perinatol 2000; 20: 466.

A cohort study of coagulase-negative staphyloccal (CONS) bactremia and central venous catheters (CVC) was conducted in a neonatal ICU over a 5 year period (1994-1998). Sixty-two cases had early removal CVC (ER-CVC) within 3 days, and 80 cases had late removal (LR-CVC) greater than 3 days after the first positive blood culture for CONS. Timing of CVC removal was a the discretion of the attending neonatologist. All cases of CONS bacteremia were treated with vancomycin. Cases of CONS bacteremia lasting >3 days occurred in 9 of 62 (15%) ER-CVC infants in contrast to 36 of 80 (45%) LR-CVC infants (odds ratio 0.21). Cases of CONS bacteremia resolved in 32 of 80 (40%) LR-CVC cases without removing CVC for > 7 days after final positive blood cultures for CONS. None of 30 infants with > 4 days of positive blood cultures showed resolution of CONS bacteremia until CVC were removed.