Catheter-related sepsis (CRS) is the most common complication of percutaneously placed central venous catheters (PCVC). We have shown that a unique program related to PCVC instituted 15 years ago at Michael Reese Hospital (MRH) improved CRS rates(1,2). The program's components were: a) only four operators (the same set of trained nurses) placed all of the PCVCs over 15 years; b) the PCVCs were replaced every four weeks; c) the dressing were changed only if there was a leak; d) blood cultures were obtained at insertion, removal and at two week intervals in between; and e) all CRS data reviewed monthly. To see if this program continued to impact CRS rates in today's NICU survivors too, we reviewed our CRS rates for 1994-96 and compared them with: a) the 1995 CDC data; and b) from a meta-analysis of sixteen publications (1990-95). 'CRS' and 'catheter colonization' were defined as per the CDC. Results: 227 PCVCs were placed in 205 infants (mean weight 1090 gms, range 400-3900 gms; 88%<1500 gms), for a total 2957 catheter days. The PCVCs were in place for a mean duration of 11.6 days (range 1-31 days). 59/227 (26.1%) PCVCs were colonized(Staph. epidermidis, the most frequent organism); however, only 8/227 (3.5%) resulted in CRS. The CRS rate defined as sepsis/ number of catheter inserted was 3.5% (95% C.I., 1.13%, 5.87%). The CRS rate defined as sepsis/1000 catheter days was 2.7 (95% C.I. 1.2, 5.3). The CDC-reported median rate for CRS in infants < 1500 gms was 14.6/1000 catheter days. The mean CRS rate computed (infants of all birth weight) from meta-analysis was 6.5%(95% C.I., 5.4%, 7.7%, range 0-29%) and 3.9 per 1000 catheter days (95% C.I. 3.17, 4.73, range 0-15.3 per 1000 catheter days). Conclusions: Compared to the CDC median rates, our overall CRS rate per 1000 catheter days was five-folds lower (our upper 95% CI, three-folds lower). Compared to the meta-analysis findings, our CRS rates were 20-40% lower. We speculate that our low CRS rates were due to the regimental program of limiting the number of operators for PCVC insertion and maintenance. Such low rates can be achieved even in today's ELBW infants. However these assumptions need to be proved in propective trials.