Percutaneous central venous catheters (PCVC) are often used for prolonged central venous access in sick newborns due to concern about infections in long-term umbilical venous catheters (UVC).

Methods: We assessed line-related bacteremia in UVC and PCVC in 230 infants admitted to a level III NICU. Bacteremia was defined as one peripheral or line culture for organisms other than coagulase negative staphylococci (CNSC). CNSC bacteremia was defined as two positive cultures or one line culture positive for >10 cfu/ml. Kaplan-Meier estimates of infection-free line survival were derived.

Results: 199 UVC and 110 PCVC were analyzed. At birth, infants were 32.4±5.2wks (UVC) vs. 29.2±4.3wks (PCVC) gestation and 1937±1022g (UVC) vs. 1267±707g (PCVC) birthweight. At line insertion, infants were 1899±1028g (UVC) vs. 1388±815g (PCVC)(p<.0001), but gestational age did not differ (UVC 32.4±5.3 wks vs. PCVC 31.2±6.6 wks, p=0.08). There were 5 infections in the UVC group (1 CNSC, 2 E. coli, 1 K. pneumoniae, 1 C. albicans) and 24 infections in PCVC group (17 CNSC, 2 M. furfur, 2 S. aureus, 1 enterococcus, 1 E. cloacae, 1 K. pneumoniae). Infection-free line survival did not differ between the two groups (Figure, p=0.17).

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Figure 1

Conclusion: The incidence of line-related bacteremia was not higher in UVC than PCVC. Indeed, our data suggest that long-term UVC may be less susceptible to line-related sepsis.