Long Line Sepsis - Neonatal
|Next review: 09/03/2026|
|Approved By: Improving Antimicrobial Prescribing Group|
|Copyright© Leeds Teaching Hospitals NHS Trust 2023|
This Clinical Guideline is intended for use by healthcare professionals within Leeds unless otherwise stated.
Guideline for the management of Neonatal Long Line Sepsis
Long Line Sepsis - Neonatal
Catheter related bloodstream infection (CRBSI) are defined as:
See full guideline for organism-specific recommendations and duration of therapy.
Duration of treatment
Switch to oral agent(s)
The definitive treatment for infection arising from a CVC is removal of the CVC and thus the source of infection. However, CVC are frequently precious assets and should be removed if the risk of leaving the catheter in situ outweighs the risk of removal and when other venous access is available. Removal of a line should always be discussed with the consultant.
|Empirical Antimicrobial Treatment|
Please refer to E-Meds protocol for specific dosing and therapeutic dose monitoring
|Duration of Treatment|
Table 1. Length of treatment of central venous catheter related sepsis.
When to Remove the Line
Central venous catheters are frequently precious assets and should be removed only:
Where recommended, the line should be removed unless the risk of removal is considered greater than the risk of not.
Line removal is strongly recommended in the following situations:
Please contact Microbiology if the patient is not responding to the recommended antimicrobial regimens.
|Clinical condition:||Suspected long line sepsis|
|Target patient group:||Infants with percutaneous and tunnelled central venous catheter|
|Target professional group(s):||Secondary Care Doctors
Secondary Care Nurses
- Mermel LA, Allon M, Bouza E, et al. Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 2009; 49(1): 1–45
- Sandoe JAT, Ian R. Witherden IR, Cove JH, Heritage J, Wilcox MH. Correlation between enterococcal biofilm formation in vitro and medical-device-related infection potential in vivo. J Med Microbiol, 2003; 52:547-550
- Lee JH. Catheter-related bloodstream infections in neonatal intensive care units. Korean J Pediatr. 2011;54(9):363-7. doi: 10.3345/kjp.2011.54.9.363.
- Blot F, Nitenberg G, Chachaty E, et al. Diagnosis of catheter-related bacteraemia: a prospective comparison of the time to positivity of hub-blood versus peripheral-blood cultures, Lancet, 1999, 354:1071-7
- Catton JA, Dobbins BM, Kite P, et al. In situ diagnosis of intravascular catheter-related bloodstream infection: A comparison of quantitative culture, differential time to positivity, and endoluminal brushing. Critical Care Medicine, 2005: 33(4):787-791. doi: 10.1097/01.CCM.0000157968.98476.F3
Improving Antimicrobial Prescribing Group
LHP version 2.1
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