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A 10 day old neonate (corrected gestation 29 weeks, birth weight 960 g) has been slow to establish feeds. Intravenous access is difficult and he is receiving parenteral nutrition through a central venous catheter (CVC). He develops temperature instability and hyperglycaemia. You decide to start empirical intravenous antibiotics but keep the CVC in situ as the infant is relatively stable. Peripherally taken blood cultures grow coagulase negative staphylococci (CoNS). Should the CVC be removed, knowing that a future replacement may be very difficult?
Structured clinical question
In a preterm neonate, with a central venous catheter in situ, who is bacteraemic with coagulase negative staphylococcus [patient], can catheter sterilisation [intervention] …
Footnotes
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Bob Phillips